Inspection on 16/02/06 for Hindmans Road, 10

This inspection was carried out on 16th February 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

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 01/09/05

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 16th February 2006 03:45 DS0000007094.V276251.R01.S.doc Version 5.1 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.V276251.R01.S.doc Version 5.1 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.V276251.R01.S.doc Version 5.1 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.V276251.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st September 2005 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 PLUS, 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.V276251.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I visited over an afternoon and early evening, speaking to two staff, speaking to one service user, and seeing the other two service users. 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. DS0000007094.V276251.R01.S.doc Version 5.1 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 DS0000007094.V276251.R01.S.doc Version 5.1 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 The home has the information they need to plan to meet service users needs. EVIDENCE: The home keeps reviews written by the authority that arranged for service users to live at the home. This says what service users need, so that the home can make plans with service users. DS0000007094.V276251.R01.S.doc Version 5.1 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, 10 Service users need more support so that their goals are planned for and met. EVIDENCE: The needs of service users have been reviewed by the authority that arranged for them to live at the home. They found that service users had not been supported to achieve the goals that were agreed. One missed goal was for a key worker to write down the strengths and needs of a service user. Another missed goal was for the manager to set up a ‘communication passport’ for a service user. The reviews found a service user was not able to go on holiday, get regular hydrotherapy, plan for their health, and find new activities, all agreed goals from the previous reviews. Service users don’t know that there is a plan written down showing staff what they need and like, and can’t remember staff sitting down and talking about their plan with them. The home have just agreed to work with CHOICE support and the multi-media advocacy project to put the decisions, wishes and feelings of service users on DVD’s showing staff what has been agreed and how to support them. DS0000007094.V276251.R01.S.doc Version 5.1 Page 9 One service user said they were supported to decide how they should pay to use another service users car. They are waiting for this to be written down as an agreement that they can sign, and change if they need to. The service user likes to use the car because they find buses too slow. One service user gets help with their money from the manager, but its not written down so that people can understand what help they get and why. The home keeps information, and things that are said by service users, and things people say about them, private. DS0000007094.V276251.R01.S.doc Version 5.1 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, 15, 16, 17 Service users meet with friends and family, but need a lot more support to get out and do new things. EVIDENCE: One service user spoke to an employment agency with help from staff, but decided they didn’t want to visit the agency to talk about work. The home need to plan to build the service users confidence. The authority that arranged for service users to live at the home reviewed the support service users get, and said “clients do not appear to be actively involved in developing their independent living skills and consequently spend lots of time observing the staff cooking, cleaning, carrying out laundry tasks and other tasks” One service user prepares for bed from 7:30pm or earlier on occasions, some evidence of a lack of stimulation. This is not planned for in writing. During the reviews 2005, social workers representing service users spent two days at the home where they saw a service user sitting in the same place for long periods. DS0000007094.V276251.R01.S.doc Version 5.1 Page 11 This was found at the last inspection visit. At this visit all of the service users were in, and staff were not sure at first if they had been out the day before either. Over a twelve day period the activities service users did were walking locally, going to church, using a local shop, driving to Lewisham, going swimming, and going to a local pub. One service user spent six of these days not leaving the home, while the other two service users spent only one or two days inside. Most activities the service users do together as a group. Activities don’t represent a good range, or of established links with the community, outside of church, and the Gateway club. One of the service users said they have spoken to the manager about something they plan to do in the summer. The home has done planning and work to use the garage for service users to undertake activities. Equipment that has been recommended for service users has been bought. One of the service users said they choose the food. The other two service users, who need more support to communicate, do not choose food, except where staff see they like something, or don’t like it. One service user is supported to eat. The staff member was prompting verbally, and rushing support, in a way that was not recommended by the speech and language therapist in their written advice for staff and the service user. One service user was able to spend time in the kitchen when food was being prepared so that they could smell it and understand some of the preparation involved. One service user helped with the cooking of food. DS0000007094.V276251.R01.S.doc Version 5.1 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): 18, 19 & 20, 21 Service users need better support that is agreed with service users and other important people in their lives that sees service users as adults. EVIDENCE: One service user saw their GP about an injury to their hand, after my last visit. Service users have not been supported to write down how they need staff to communicate with them. One service user has been seen by a health professional who feels that are at risk of losing weight. The home has not brought scales to monitor their weight. The home is waiting for the physiotherapist to find scales for them. The home support service users with their health needs, referring them to physiotherapist and speech and language therapists when this is needed. They didn’t involve a service users social worker soon enough when they had a planned operation last year. The home has agreed to do this in future. Two of the medications labels disagreed with the size of tablets written down on the medicine administration record. One service user has medication they can use when they need it. They take it regularly every fortnight, but it isn’t helping them since they feel in pain most nights. DS0000007094.V276251.R01.S.doc Version 5.1 Page 13 One of the service users needs to talk a lot about death and dying but this isn’t planned for, and they haven’t had the chance to write down what they would like to happen. DS0000007094.V276251.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Service users can complain and know that staff listen. EVIDENCE: The home has a book to write down when people complain. Staff need to make sure they write down a short note when they get informal complaints as well. DS0000007094.V276251.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27 & 30 Service users live in a comfortable, clean home. EVIDENCE: The leaking tap and other problems were fixed after my last visit. The manager said service users can adjust the heating in their rooms, and one service user said this is right. The home is comfortable, with enough space for service users to be alone or spend time together. They have enough storage in their bedrooms, and enough toilets and bathrooms so they can choose which one they like to use. The home is clean and hygienic. DS0000007094.V276251.R01.S.doc Version 5.1 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): 32, 33 & 34 Service users cannot be sure that there will be enough staff to support them inside or outside of the home, or that they will respect their dignity. EVIDENCE: When I arrived one staff was working alone, and this continued for three hours. The deputy manager recognised that the home is short staffed at times. The home had agreed they needed a minimum of two staff at any one time during the day. One staff member shouted to get the attention of a service user, causing them to jump. Staff try to reassure one service user by stroking the back of their head, using language that does not respect their dignity as adults, and standing over them. A new staff member has done the Learning Disability Award Framework induction and foundation training. Staff have recently had training in organisational roles. Some of the staff feel they work in the same way at this home as other homes they occasionally work, run by the same organisation. The organisation will confirm that they have all relevant staff checks in place before 31.03.06, and this will be included in the next report. DS0000007094.V276251.R01.S.doc Version 5.1 Page 17 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): 39 & 40 Service users need the organisation to make sure that the quality of care improves at the home a lot, and that there are enough staff, and the right people to help them make their own decisions, and express their wishes and feelings. EVIDENCE: The home have just started working with CHOICE support and the multi-media advocacy project to make plans at the home more about what service users want and need. The home will need to build on this work by drawing up a plan for the home that is reviewed every 12 months. Someone visits the home every month to look at how well the home is doing, and anything that needs to be done. The home had removed old policies so that staff know what to look at to check what they should be doing. DS0000007094.V276251.R01.S.doc Version 5.1 Page 18 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 x ENVIRONMENT Standard No Score 24 3 25 x 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 1 34 x 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 1 x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 1 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 1 1 3 X X 2 3 X x X DS0000007094.V276251.R01.S.doc Version 5.1 Page 19 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 YA6 Regulation 15 Requirement Timescale for action 30/04/06 2 YA6 15 The Registered Person must ensure that service users’ goals are planned for and kept under review, including a key worker to write down the strengths and needs with a service user, the manager to set up a ‘communication passport’ with a service user, annual holidays, hydrotherapy for a service user, a health action plan for a service user, the identification and planning for new activities with a service user, and any other unmet goals. The Registered Person must 30/04/06 ensure that service users are supported to find out about Person Centred 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 DS0000007094.V276251.R01.S.doc Version 5.1 Page 20 3 YA7 12(2) 4 YA7 12(2) 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.(timescale of 30/10/05 not met) The Registered Person must 30/04/06 ensure that the service user described has a written agreement to be supported to with access to their money, and how it is spent, including support to purchase insurance. (timescale of 30/11/05 not met) 30/04/06 The Registered Provider must 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, and now 31/12/05 not fully met) Enforcement action may be taken if this Requirement is not met. 5 YA16 12(2)(3) The Registered Person must DS0000007094.V276251.R01.S.doc 30/04/06 Version 5.1 Page 21 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. (timescale of 31/12/05 not met) 6 YA17 12(2) 16(2)(i) The Registered Person must 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.(timescale of 30/10/05 not met) The Registered Person must ensure that the service user is weighed regularly as recommended by the physiotherapist, or grounds for not doing this discussed and agreed with them, and any action taken to manage the risk of the service user losing weight and/or not eating, to safeguard their health and well-being. 30/04/06 7 YA19 12(1)(a) 13(4) 31/03/06 8 YA20 13 31/03/06 The Registered Person must ensure that the service users medication described is recorded so that the dosage on the Medication Administration Record agrees with the changing prescriptions. (timescale of 30/09/05 not met) The Registered Person must 30/04/06 ensure that the service user is supported to review their medication, and follow advice and guidance from the service users GP to manage the pain DS0000007094.V276251.R01.S.doc Version 5.1 Page 22 9 YA20 13(2) they experience. 10 YA32 12(4)(a) The Registered Person must 30/04/06 ensure that staff receive training and supervision support to understand best practice and their role and responsibilities in the home, to respect the dignity of the service user described. The Registered Person must 30/04/06 ensure that staffing levels at the home are reviewed, including the practice of lone working during the day, against the needs of service users, a copy sent to the Commission for Social Care Inspection (CSCI). The Registered Person must ensure that service users are consulted and supported to make a plan to improve the quality of care provided at the care home and reflect their decisions, wishes and feelings in the way the home is run. 30/06/06 11 YA33 12(1)(a) 12 YA39 24 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 YA21 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 staff work with the service user to build their confidence about the process of getting a job. The Registered Person should ensure that informal complaints are recorded in the complaints record so that staff can show they support service users to resolve DS0000007094.V276251.R01.S.doc Version 5.1 Page 23 2 3 YA12 YA22 problems before they become serious. DS0000007094.V276251.R01.S.doc Version 5.1 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000007094.V276251.R01.S.doc Version 5.1 Page 25 - 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. 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