Inspection on 01/09/05 for Hindmans Road, 10

This inspection was carried out on 1st 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hindmans Road, 10 15/09/08

Hindmans Road, 10 24/09/07

Hindmans Road, 10 15/03/07

Hindmans Road, 10 16/02/06

Hindmans Road, 10 17/03/05

Hindmans Road, 10 18/08/04

Hindmans Road, 10 30/03/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Hindmans Road, 10 London SE22 9NF Lead Inspector Mark Stroud Unannounced Inspection 01/09/05 10:00 DS0000007094.V250640.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 DS0000007094.V250640.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. DS0000007094.V250640.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hindmans Road, 10 Address London SE22 9NF 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) 0208 693 8950 LINC Mr Patrick McCann Care Home 3 Category(ies) of Learning disability (0) registration, with number of places DS0000007094.V250640.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17/03/05 Brief Description of the Service: 10 Hindmands Road is a Care Home providing accommodation and personal care to three people with a learning disability, currently all men. Hexagon Housing Association, a voluntary organisation who leases the building to CHOICE support, owns the building. The service is provided by LINC, a voluntary organisation. The home is located in East Dulwich, close to shops, Peckham Rye Park, pubs, the post office and other amenities. The home consists of a two-storey building, one bedroom downstairs with ensuite facilities, and accessible to wheelchair users. All the home’s bedrooms are single. The home has a garden to the rear. DS0000007094.V250640.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A single inspector visited the home in the afternoon; saw all of the service users, and three staff. What the service does well: What has improved since the last inspection? What they could do better: Service users don’t have a written plan that helps them see how they are supported and ask to change this, and helps them to explain to staff what they want and when. Service users who are quieter, or aren’t able to say what they want so well, need more reliable support to try new things, decide where they want to be, and be able to say how they feel. DS0000007094.V250640.R01.S.doc Version 5.0 Page 6 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. DS0000007094.V250640.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 DS0000007094.V250640.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): None of these Standards were inspected during this inspection. EVIDENCE: DS0000007094.V250640.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 , 9 & 10 Service users are not able to refer to a written plan that tells people what they have agreed with staff about how they are supported. EVIDENCE: Service users have a plan for the activities they will be supported with inside and outside of the home. The home help to support service users with things that might be dangerous in the community, but what’s written down says different things about how many staff are needed for one service user. The home also need to agree how they support the existing skills service users have for their personal care, and to develop new skills. One of the service users has put on weight, and another service user is at risk of losing weight. The support they need must be included in their plans that they agree, or are supported to agree by a friend, relative, or the authority that arranged for them to live at the home. Staff who are new to the home say that more experienced staff explain the needs of service users. Service users need to agree how they are supported, including things like keeping the toilet door shut for their own and other privacy. The home do not keep a description of service users with an up to date photo, their basic details like age, build and basic needs, so that this can be given to the police or other emergency DS0000007094.V250640.R01.S.doc Version 5.0 Page 10 services should they go missing, or become ill. One service user is waiting to go away after their holiday was cancelled at short notice due to staff sickness. A new holiday is promised this year but no evidence was found that this is being planned with the service user or their representatives. The last review for one service user was two years ago, and plans for the home to become a ‘total communication environment’. Staff were not seen using symbols or other specific communication with service users, and service users plans did not describe in detail the way service users communicate and how staff should support this. One staff member said that one service users communication, and the way they were behaving, meant they were unhappy, and said to them ‘that’s bad’, but it wasn’t clear from what was written down that it was bad, or what staff should do to support them, except that staff should avoid an ‘angry tone’. One of the service users said they are not allowed to remove their money from their tin, and have been supported to pay life insurance by the manager, but there was no written agreement about how they are supported. Other service users have been supported to make important decisions about their health, by involving their family, friends, and the authority that arranged for them to live at the home REQ. Service users were happy that they are able to keep to their own routines when getting up and going to bed. Two of the service users share their car with the other service user and this needs to be agreed in a contract, so everyone knows what they pay for and how much, as well as how to change the agreement if people want to stop using the car, or start using the car. Staff do need to keep up records of activities if this is what service users need. DS0000007094.V250640.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, 16 & 17 While most service users are active, service users who are less able to advocate for themselves, either verbally or through their behaviour, are not reliably supported to try new activities, express their wishes and feelings, and make informed decisions about what they want to do. EVIDENCE: In general service users are able to participate in a variety of activities, including cycling, going to the gym, as well as relaxing at home, or following planned activities at home. One service user who has a lot of planned activities inside does not go out so much. The week of the inspection they were in four days out of seven. While at home they use equipment designed to entertain them and help them make choices, but on the day of the inspection visit they stayed in their room in the same position for a three hour period, mostly without direct staff support. One service users review notes from three years ago said they should have new equipment for their room, which hasn’t been purchased. The home are still planning to use the garage for service users to follow activities but it isn’t clear when work will be done and the space ready for service users to use comfortably. Service users are able to go church, and DS0000007094.V250640.R01.S.doc Version 5.0 Page 12 go on holiday every year. Service users take part in the upkeep of the home, cleaning the windows, doing their laundry, preparing meals, with the support they need from staff. One of the service users wants to work, for their enjoyment and wellbeing, and so they can have more money. The home has supported them to get in touch with an employment project, and they used to work locally. The plans for them to be supported towards a new job are not written down. Service users eat a variety of foods, eating out and getting takeaways sometimes. One of the service users didn’t want the meal planned on the day of this visit but didn’t feel they could get an alternative. One of the service users needs support to eat and this wasn’t found written down, so staff can be consistent and know they are doing the right thing. DS0000007094.V250640.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, 20 & 21 Service users are supported with their personal care, appearance and personal hygiene in a way that respects their dignity. Support with medication is not always clearly recorded. EVIDENCE: Staff and service users are no longer using the service users en-suite toilet downstairs. There are always two staff on duty now, so that service users have the support they need inside and outside of the home. Service users are able to share their wishes and feelings with a staff member they can work more closely with. One service user needed more support to keep themselves clean, but staff generally support service users to change their clothes before they go out if they need to, and to keep up health appointments like the optician, dentist, well-men clinic, and GP to review their medication. One service user had a swollen finger, which may have needed medical attention, but they felt they hadn’t seen their GP or someone who could advise them well. One of the service users says they don’t sleep well and get anxious about things, and another service user has lots of health needs, but the support for this is not written down and agreed with them. One of the service users said they worry about dying, and know what they want to happen if they die, but they don’t have this written down and agreed, and they haven’t had the chance to decide if they want a will. All the service users are supported to take their medication DS0000007094.V250640.R01.S.doc Version 5.0 Page 14 well, but one service user whose medication is changing, wasn’t clearly getting the support they need. DS0000007094.V250640.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): 23 Service users are supported by staff who help them to protect themselves from people who might want to hurt them. EVIDENCE: New staff are told how to keep service users safe, and how they may know if service users are not safe or have been hurt or abused, and they are asked to show that they understand what they have been told. The home have a written document so that all staff can do the same thing if they are worried service users have been hurt or are being abused, so that the people who need to know are told, and everyone works together to keep service users safe, and support them to tell the police if they need to. DS0000007094.V250640.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, 26, 27 & 30 Service users live in comfortable surroundings, that allows them privacy and good communal space. EVIDENCE: The home is comfortable and decorated. Everyone is able to sit where they like, and to have their own chair if they want to. There are some things that need to be repaired or changed including the coffee table, the lounge curtains, which a service user would like changed, the shower curtain, which is worn and stained. There is new garden furniture where the service users can eat their food, and plants are kept around the home. One service user says they get too hot at night. The home has renewed the heating system so that service users each have a control in their room for the heating. The ceilings and high surfaces are dusty, but generally the home is kept very clean and tidy. The walls above some heaters are stained. There’s a leaking tap in the bath/shower room, and the tiles are coming away from the wall in one place. Staff don’t use the downstairs en-suite toilet now. The upstairs toilet door is wedged open, which makes it more difficult for service users to close. Staff say they do encourage service users to close the door for privacy. DS0000007094.V250640.R01.S.doc Version 5.0 Page 17 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): 35 Service users are supported by trained staff. EVIDENCE: A new staff member recently started work at the home. They have started their induction, and showed they understood some of what service users needed. Two staff are always on duty now. New staff are helped to start studying and being assessed for their National Vocational Qualification (NVQ) a nationally recognised qualification to show that care workers can provide good safe care. Staff are clear about who is in the charge of the home but this should be written down if people are unsure. Staff do a lot of general training like first aid, and how to move people safely, as well as training designed to teach them how to support people with a learning disability they way they want. Staff know that if someone is not able to work when they are unwell they can arrange for other staff to come instead, so service users and staff get the support they need. Staff know how to get more help if they aren’t sure what to do, at any time of the day or night. DS0000007094.V250640.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, 40 & 42 Service users know the home is safely run. EVIDENCE: The manager hasn’t changed since the last inspection and has worked at the home for some time. The Commission for Social Care Registration (CSCI) Registered him, which means they feel he is able to manage a care home, and has the right qualifications to do the job. This inspection found that this was right. Service users are now supported to take cleaning products out of a locked cupboard so that they don’t get hurt using them. Staff can look at written advice showing them what to do, but some of this advice is old, and might confuse them into doing the wrong thing. This needs to be removed, so staff only look at the new advice. DS0000007094.V250640.R01.S.doc Version 5.0 Page 19 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 x x x x Standard No 22 23 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 x 2 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 2 x x 2 LIFESTYLES Standard No Score 11 x 12 2 13 3 14 x 15 x 16 2 17 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 3 Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x 3 x DS0000007094.V250640.R01.S.doc Version 5.0 Page 20 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 6, 12, 19 & 27 Regulation 15 Requirement Timescale for action 31/01/05 2 7 12(2) The Registered Person must ensure that service users are supported to find out about Person Centered Planning, and to make one for themselves, involving their friends, family and professionals, including a representative from the authority that arranged for them to live at the home. Plans must be kept up to date and include sufficient details about support including how to communicate, sleep patterns and mental health, general health needs, how many staff will support service users inside and outside of the home, towards employment if this is a service users wish, support to maintain their privacy including the use of the toilet if necessary, support to go on holiday, and a summarised overview including a photo, their needs, information for identification, and how they want to be supported, so that emergency services have a good record if they need it. The Registered Person must 30/11/05 ensure that the service user DS0000007094.V250640.R01.S.doc Version 5.0 Page 21 described has a written agreement to be supported to with access to their money, and how it is spent, including support to purchase insurance. 3 7 & 23 12(2) The Registered Provider must 31/12/05 ensure that the arrangements for the use of the vehicle by service users who do not own it, including payment for it’s running and maintenance if any, is agreed and recorded. The purchasing authorities must be consulted, and other stakeholders as appropriate. Advocate support must be provided where required. All written information must be made accessible to service users and explained to them. Copies must be forwarded to the Commission for Social Care Inspection (CSCI).(Timescale of 30.06.05 not met) Enforcement action may be taken if this Requirement is not met. 4 10 17 The Registered Person must 31/10/05 ensure that where records are kept about activities service users have done, or any other information agreed as part of their plans, is kept up to date and complete. The Registered Person must 31/12/05 ensure that the service user described is supported to purchase equipment as agreed at their review, or where this decision has changed, record this in the service users plan, with the involvement and agreement of the purchasing authority. The Registered Person must 31/12/05 Version 5.0 Page 22 5 12 16 6 16 12(2)(3) DS0000007094.V250640.R01.S.doc ensure that the service user described is supported to choose where they sit and what they do, to be made aware of suitable activities outside of the home so they can make an informed choice, and supported to express their wishes and feelings regularly. 7 17 12(2) 16(2)(i) The Registered Person must 30/10/05 ensure that service users can choose the food they eat, providing alternative meals where necessary, and that support for the service user described to eat is written down, and informed by professional assessment. The Registered Person must 30/09/05 ensure that a health practitioner is consulted, and injuries to the service user described properly assessed and treated, by their GP if this is advised. The Registered Person must 30/09/05 ensure that the service users medication described is recorded so that the dosage on the Medication Administration Record agrees with the changing prescriptions. The Registered Person must 31/12/05 ensure that the coffee table, the shower curtain, the tiling around the bath, and the leaking tap, are replaced or made good, The Registered Person must 31/12/05 ensure that the service user described is supported to adjust the heating in their room and change the bedding they use according to the season. The Registered Person must 30/10/05 Version 5.0 Page 23 8 19 12(1)(a) 10 20 13 11 24 23 12 26 16(2)(c) 23(2)(p) 13 30 13(3) DS0000007094.V250640.R01.S.doc ensure that ceilings and other high areas are kept free from dust, and walls above heaters kept clean or redecorated. 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 21 Good Practice Recommendations The Registered Person should ensure that the service user described is supported to record their wishes regarding death and dying, making a will if necessary, and to discuss their wishes and feelings and death and dying. The Registered Person should ensure that the service user who would like the lounge curtains changed is supported to make a decision with the other service users. The Registered Provider should ensure that old policies and procedures are removed form the working policies and procedures file, to avoid confusion. 2 3 24 40 DS0000007094.V250640.R01.S.doc Version 5.0 Page 24 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. 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