Inspection on 15/04/05 for High Street, 56

This inspection was carried out on 15th April 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

High Street, 56 02/12/09

High Street, 56 31/12/07

High Street, 56 31/08/06

High Street, 56 06/09/05

High Street, 56 29/11/04

High Street, 56 13/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE 56 High Street 56 High Street Chislehurst Kent BR7 5AQ Lead Inspector Rosemary Blenkinsopp Unannounced 15 April 2005 10:20 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 Older People. 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. 56 High Street Version 1.10 Page 3 SERVICE INFORMATION Name of service 56 High Street Address 56 High Street, Chislehurst, Kent BR7 5AQ 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 8468 7016 Community Options Limited Mr James Oseya Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places 56 High Street Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 10 Elderly persons of either sex suffering with mental illness. Date of last inspection 29/11/04 Brief Description of the Service: This facility is part of the Community Options group of homes. This service is registered for ten residents in the category of mental disorder, excluding learning disability. At the time of the visit there were nine residents in the home, one was in hospital. The home is a large detached house in the centre of Chislehurst High Street. There are three floors and bedrooms are located over two floors. There are two sitting areas and a separate dining facility. There is a dedicated smoking room. The service is for those residents who have long-term mental health problems. Staffing is provided throughout the 24-hour period including waking night staff. 56 High Street Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived at the home at 10.20 am. The manager was on duty with two support workers, a domestic and one cook. The inspector met with one support worker and the cook. Two residents were spoken to at length, two others briefly. A tour of the home was undertaken. Two staff met with the inspector. Four residents were spoken to during the inspection. No visitors were available to give feedback. Records and supporting documentation were viewed as detailed in the report. 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. 56 High Street Version 1.10 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection 56 High Street Version 1.10 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective residents have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Residents and their representatives know that the home they enter will meet their needs. Prospective residents and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Residents assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4,5 The choice of home was appropriate to the assessed level of need for residents. EVIDENCE: There have been no recently admitted residents and therefore the assessments could not be verified, however the templates for obtaining assessment information were available and suitable to this client group. Admissions to this home are fairly infrequent, the last resident having been admitted three years previous. Within two care plans, documentation was in place including the original assessments, which were conducted by staff working for Community Options. These were signed by residents. Introductory visits are offered and in some cases an overnight stay can be facilitated. In reality residents have a limited choice in their placement, as there is limited provision for this category of resident. One care plan had the resident’s agreement whilst the second did not. 56 High Street Version 1.10 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Residents’ health care needs are fully met. Residents, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Residents feel they are treated with respect and their right to privacy is upheld. Residents are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The inspector considered that the information provided in the care plans did not accurately or comprehensively address the residents’ needs. The needs, which had been identified, had limited interventions detailed, which were insufficient to address the problem. EVIDENCE: Care plans were available for all residents, although in this home they are referred to as support plans. The care plans contained the assessment information and identified needs. Supplementing information from the Care Programme Approach (CPA) was also available. Residents are supported to develop their own care plan with staff assistance. The care plans viewed were limited in their content in respect of the identified needs and the intervention needed to address the problem. One example of the limitations of the care plan was that the resident needed to have a weekly bath. This was the objective. The action to meet the objective stated “(1) Neglects her personal hygiene and unable to give herself a bath. (2) Staff to persuade her to have a bath”. The care records required more detailed actions by staff to achieve the aim. 56 High Street Version 1.10 Page 9 The care plans contained limited information in relation to mental health needs or rehabilitation. Care plans had been identified at the previous inspection as requiring further development as well as the supporting risk assessments. Medication charts were completed with the exception of the allergies section. Within the medication cabinet two medications had expired indicating regular monitoring of medication was not taking place. Please see requirements 1 and 2. 56 High Street Version 1.10 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Residents maintain contact with family/ friends/ representatives and the local community as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The evidence gained during the inspection was that residents had choices in their day including rising and retiring times. Recreational and social activities are encouraged. EVIDENCE: During the visit residents were spending time where they wished and engaging in activities as they wished. Television seemed the main source of entertainment. TVs and radios were available in individual bedrooms as well as communal areas. The manager advised the inspector that three residents have no visitors and independent advocates were not available nor did the residents want any external involvement. One resident confirmed this. Residents are able to partake of the local amenities and some do so. Two residents attend day centres at regular intervals. Three residents commented that the food was very good and choices were available. Hot/cold drinks were available at any time, which was evident during the inspection. Visiting is open and encouraged. Some residents go home to visit their families and overnight stays can be facilitated. There has been discussion regarding summer outing with day trips having been the preferred option. 56 High Street Version 1.10 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Residents’ legal rights are protected. Residents are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 The training for adult protection was satisfactory as were the systems for raising concerns/ complaints. EVIDENCE: Information advising residents on how to make a complaint was available in various forms. The complaints procedure was on display and this is included in the Residents Guide and the Statement of Purpose. In the event that a complaint is raised senior staff from head office would investigate the matter. In addition Senior Management conduct Regulation 26 visits and as part of these meet with residents about the home and the staff. Residents stated that they would raise issues within the home with the staff, although did not relate other external avenues for raising concerns. Staff training in relation to adult protection was confirmed by staff and the manager. 56 High Street Version 1.10 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Residents live in a safe, well-maintained environment. Residents have access to safe and comfortable indoor and outdoor communal facilities. Residents have sufficient and suitable lavatories and washing facilities. Residents have the specialist equipment they require to maximise their independence. Residents’ own rooms suit their needs. Residents live in safe, comfortable bedrooms with their own possessions around them. Residents live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,23,24,25,26. The environment has significantly improved since the last inspection, however to maintain it to a satisfactory level will require continual staff input. EVIDENCE: The home had improved since the last inspection having benefited from redecoration and carpeting with further work planned. Those bedrooms, which were viewed, were to a satisfactory standard with the exception of one, which was in a poor state. The carpet and furniture had all suffered cigarette burns. The manager advised the inspector that this is due to be completely refurbished with high specification robust furniture and flooring. The smoking area, the lounge, had greatly improved although evidence of cigarette burns was already present with burn holes in the carpet. This area had only been completed very recently. Staff need to be extra vigilant around smoking not only for safety reasons but also to maintain the home. Please see requirement 3. 56 High Street Version 1.10 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Resident’s needs are met by the numbers and skill mix of staff. Residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 The home has sufficient staff to meet the residents’ needs. Staff are provided with appropriate training to meet the residents’ needs. EVIDENCE: The inspector met with two staff, the cook and one support worker. Both demonstrated a good knowledge of the residents in the home. They gave an outline of the training that they had received whilst working for Community Options. Staff confirmed that the training they had received had included statutory topics and those specific to mental health. Both staff were able to advise the inspector of the line management systems for the company and the on call arrangements. Staff personnel files are located off site at the Head Office. On inspecting these with Mr Turner, Regulation Manager, in 2004, they were found to be to a good standard. These will be re-inspected 2005. 56 High Street Version 1.10 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Residents live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Resident’s benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of residents. Residents are safeguarded by the accounting and financial procedures of the home. Residents’ financial interests are safeguarded. Staff are appropriately supervised. Residents’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of residents and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35,38 The manager is suitably qualified and experienced to manage this facility. One disadvantage is the remote location of the office in relation to the main areas of the home. EVIDENCE: The manager, Mr Oseya, has completed his fit person process through the CSCI. He has managed several facilities with this company and is a trained nurse in the field of psychiatry. Health and safety records were inspected and the majority were in place with the exception of the portable appliance testing record, which could not be located. The lift inspection had identified four areas to be addressed. The fire risk assessment needs dating. Financial systems and policies ensure the safe keeping of residents’ money. 56 High Street 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 Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 3 x 2 2 2 2 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 x 3 3 x x 2 56 High Street Version 1.10 Page 16 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 7 Regulation 15 Requirement The Registered Person must ensure that care documentation is comprehensive and reflective of residents needs including physical, social and psycological. Previous date for completion 31/1/05 The Registered Person must ensure that medication systems are robust including record keeping, auditing and record keeping to ensure safe practice.Previous date for completion 31/12/04 Th Registered Person must ensure that the home is well maintined in all parts with staff input to retain it to a satisfactory level. Previous date for completion 31/12/04 Timescale for action 30/6/05 2. 9 13 30/6/05 3. 19 23 30/6/05 56 High Street Version 1.10 Page 17 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 38 Good Practice Recommendations The Registerd Person should forward an actioon plan in relation to the four recommendations arising out of the lift inspection 56 High Street Version 1.10 Page 18 Commission for Social Care Inspection River House 1 Maidstone Road Sidcup DA14 5RH 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. 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