Inspection on 19/02/07 for Homeleigh Residential Care Home

This inspection was carried out on 19th February 2007.

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 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

Homeleigh Residential Care Home 06/02/09

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

CARE HOME ADULTS 18-65 Homeleigh Residential Care Home 52 Eglinton Hill Shooters Hill London SE18 3NR Lead Inspector Keith Izzard Unannounced Inspection 19th February 2007 10:00 Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 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 Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 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. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homeleigh Residential Care Home Address 52 Eglinton Hill Shooters Hill London SE18 3NR 07947 110541 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) Lovestar Limited Ms Stella Abimbola Olonimoyo Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/a Brief Description of the Service: Homeleigh House is a five roomed bungalow situated in the Shooters Hill area providing residential supported accommodation within a rehabilitation unit for adults with mental health problems. The home provides specialist care for people who may have challenging behaviour and forensic psychiatric history and may be on a supervision register and are recovering or have recovered from mental illness. The accommodation comprises self contained bedrooms with en-suite facilities, a large communal area, dining area, kitchen bathroom, quiet room, laundry and games area. The house is well situated for local amenities within the Woolwich area and local transport. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this unannounced inspection was completed over a period of 5.5 hours on 19/02/07. Three members of staff including the registered manager assisted the Inspector in a constructive and helpful manner. Both the service users currently accommodated were present and assisted the Inspector by providing information about themselves particularly in respect of the service provided to them by the home, both stated that the service was of good quality and that they were happy with both the home and the staff members. The inspection included a review of information received about the service, a tour of the premises, an examination of records, including care plans, talking to and observing two residents’ interaction with members of the staff team. There was a happy and positive atmosphere in the home on the day of inspection and residents appeared well cared for by staff members who were observed to be both caring and professional in their approach with residents. What the service does well: Service users were involved in the day-to-day running of the home, they were also encouraged to speak up and to say what they wanted and said they did this at the regular service user meetings. The level of activities provided both internally and externally was appropriate to the needs of both service users. Both service users had received good health care and medication was safely dealt with. The home was comfortable and spacious and service users’ bedrooms were personalised with their own possessions. Both service users said that staff treated them well and felt that the manager and staff were doing an excellent job. The staff team made efforts to make the environment as homely as possible for residents and interaction with residents observed was seen to be both caring and professional. Good attention was given to meeting residents’ individual needs. The home had been operational for six months at the time of the inspection and it was evident that the manager had given great attention to ensuring that the National Minimum Standards for younger adults had been addressed and Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 6 complied with as much as could be expected within that short timescale. This was reflected in that only one recommendation was made arising from this inspection, a commendable achievement. 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. The summary of this inspection report can be made available in other formats on request. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 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 Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed to ensure that their needs can be met. EVIDENCE: Standard 2 The personal care files of both service users were examined. These included detailed referrals comprising assessments completed as part of the care management process and reports from professionals such as psychiatrists, and other therapists. Both the files included a care plan and the provider stated that the care planning and risk assessment process starts before admission to the home and takes up to one month to fully complete. Both service users had clearly been involved in the setting up of their care plans and had signed them. Goals for development had been clearly identified and the process by which care staff members would achieve them and reviews of care clearly scheduled with input from both Community Psychiatric Nurses and care management. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users care plans show that they have been involved in their compilation as they were individually signed. Service users are supported to make their own decisions. Risks are identified and managed safely. EVIDENCE: Standard 6. Two care files and individual plans were examined in respect of both the service users. Individual plans were comprehensive and involved both service users and their representatives, including family or advocates and other professionals involved. These plans are reviewed with outcomes clearly stated and agreed by all participants. Records seen were comprehensive and up to Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 10 date and records included appropriate risk assessments. Where risks were identified procedures and care plans reflected how these were being managed. For example one service user only goes out when accompanied by a staff because of concerns regarding vulnerability and the other has a reporting regime to phone at certain times and is required to return at specified times, this is part of an agreed CPA programme. Standard 7 Service users are encouraged to make decisions wherever possible in respect of activities, food, domestic tasks, the décor and layout of their rooms, their personal appearance and clothes they choose to wear. One service user interviewed stated that she had chosen the colour scheme for her room and her relatives had helped her decorate the room. All service users’ rooms were seen and all were highly personalised. Standard 9 Independence is promoted where possible. Risk assessments were available in both service user’s care files and are readily available for all bank or agency staff who may be less familiar with service user’s needs. Any restrictions placed are minimal these are recorded in the care plan and would be for the safety and welfare of service users, as identified in Standard 6 above. Evidence was available from the service user’s records examined and from discussion with both service users that they are enabled to express choice in what they do. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users take part in appropriate activities and are part of the local community. Service users are supported to have appropriate relationships. Rights are respected and responsibilities recognised in service users lives. EVIDENCE: Standards 12 -16 One service user attends a day centre twice a week accompanied by a member of staff who stays with the service user owing to episodes of challenging behaviour, the intention is to progress to a point where staff remaining present Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 12 is withdrawn eventually. Other regular external activities include going shopping and out for walks accompanied by a member of staff. Organised activities within the home include 1:1 counselling sessions three times weekly art, cooking, relaxation, group discussion, current affairs, cards and bingo. The other service user has specialist input from a drug and alcohol unit regularly once a week outside of the home, visits his girlfriend once a week and organised activities within the home such as dominoes, board games, group discussions, relaxation, cooking and current affairs. This service user is currently working toward a part time job in a local supermarket and attending a local Gym and possibly college in the future. Both service users have a scheduled regular activities list covering each week and additionally have access to a communal TV, computer and purpose designed games room as well as their individual rooms when privacy is required. Both service users commented positively on the activities provided for them and that they were enabled to express their opinion and personal choice in both these matters and all other aspects of their lives. Both service users are encouraged to maintain family or other significant relationships, one receives regular visits from her father and the other maintains regular weekly contact with a girlfriend. Standard 17 The Inspector was provided with a menu planner for a period of four weeks that showed that a variety of food was provided and that an adequate nutritional diet was maintained. Both service users were encouraged to participate in the preparation of food at any time, but particularly in the evening. Both service users stated that they were pleased to be involved in the preparation of food in order to promote their independence and that they were encouraged to make their own choices in respect of formulating the menu and that the food was of good quality. A weight plan had been introduced for one service user but recently ceased owing to an improvement in body mass. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive flexible personal support. The physical and mental healthcare needs of service users were met. The medication system for the home was well organised and recorded. EVIDENCE: Standard 18 Neither service user requires physical assistance with their personal care other than some prompting for one of them. This person, was being provided with counselling and encouragement by staff members to boost self esteem and personal appearance. The other service user expressed very positive views of how supportive staff members had been toward him. Evidence was available both within the care file and from observation that there had been considerable success in this area and the staff members are commended for their Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 14 achievement. Both service users commented that staff members were considerate toward them and that they felt respected by them. Standard 19 Evidence was available from both care files examined that both service users were enabled to manage their own health care and this was evidenced by regular contact with Psychiatric health professionals for both. Also around issues of weight gain, increased smoking control and less challenging behaviour for one and reduced dependence on drugs and alcohol for the other. Both service users are registered with a local GP and one receives an injection at the local surgery bi-weekly. One service user receives ongoing treatment from a Chiropodist. Standard 20 Both service users stated that they were happy for staff members to assist them with their medication and did not express any desire to self medicate. In one instance this would not be advisable in any case. The medication system was examined and was appropriately organised; medication was stored in a locked cabinet and quantities and dosage of medication tallied with the MAR sheets examined. The home had a policy and procedure for medication that was comprehensive and only staff members who had received training were allowed to deal with medication. The manager stated that advice was readily available from the supplying Pharmacist. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate procedures were in place to ensure complaints were managed and to protect residents from abuse. EVIDENCE: Standard 22 The home had policies and procedures in relation to complaint management. A system was in place to record complaints made about the service. No complaints had been made to the provider since the home opened. Nor have any complaints had been received directly by the Commission. Both service users have the capacity to raise concerns and when spoken to by the Inspector both indicated that they were very happy within the home and had no complaints. Standard 23 The home had policies and procedures in relation to adult protection and as whistle blowing policy. No allegations of abuse had been made to the provider or the Commission since the last inspection. The home did not have a copy of Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 16 the London Borough of Greenwich Adult Protection Procedures and it is recommended that this is obtained, be shown to staff members and to ensure that the homes policy matches the requirements within the local authority procedures. Those staff interviewed by the Inspector indicated a good understanding of adult protection and how they would manage such a situation. However, the Inspector recommends all staff should receive updated training in this area as soon as practicable. See Recommendation 1 Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable safe environment that was spotlessly clean and tidy on the day of inspection. EVIDENCE: Standard 24 The home was clean, bright and comfortable. Bedrooms were spacious and highly personalised, this is commendable, and there was ample communal space for service users. The Inspector was informed that the patio area to the rear of the building was being developed and that in due course a conservatory would be attached to the rear of the dining room. Standard 30 Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 18 The Home was spotlessly clean and tidy on the day of the inspection, and liquid soap and towels was available in the bathrooms and toilets. The kitchen work surfaces were clean and tidy with utensils and equipment appropriately stored. All cleaning materials were locked away and subject to COSHH procedures. A problem had been identified with the drainage from one en suite facility but evidence was available that this had been attended to. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment practices were satisfactory. Staff training was comprehensive and a high level of staff members qualified above the minimum Standard requirement had been achieved. EVIDENCE: Standard 32 Training records for individual staff members were seen and this showed that a good level of training had been provided and was being planned for the future. Induction training had been provided for all new staff and foundation training following this. From observations made of care worker practice and the evidence of training provided for staff the Inspector felt that, overall, there was a good level of skills and experience and that those staff observed had the requisite skills, attitudes and characteristics necessary to adequately support service users. Staff members were observed to be respectful and caring in the way they were relating to service users. It was equally evident that service users were Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 20 content within their environment and responding positively to any staff interventions. Standard 34 Two personnel files were examined for staff members and recruitment practice were found to be in accordance with the requirements of Regulation 19 and Schedule 2 of the National Minimum Standards. Proof of identity and photos were included on the personnel files and also evidence obtained of the physical and mental fitness of workers had been complied with. Two members of care staff were interviewed and both stated that they had received a thorough recruitment and induction programme when they commenced working for the home. Standard 35 At this inspection the Inspector was informed that both of the care staff have achieved NVQ level 2 and that the other three staff are first level nurses this exceeds the National Minimum Standards. The manager provided evidence of a training plan for the year 2006-2007 and this was comprehensive. All staff members had received induction and foundation training and had, in place, an individual training and development plan. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well run. Quality assurance mechanisms were being developed and surveys of service users and others involved with the home were about to be developed. The health and safety of service users was promoted. EVIDENCE: Standard 37 The manager is a very experienced and competent mental health professional having a comprehensive background in various areas of NHS psychiatric provision. Two staff members and the two service users interviewed were all very positive about the way the home was managed and the support and advice Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 22 available to them offered by the manager. All commented that they would not have any hesitation in approaching her about any concerns either in respect of the welfare of service users or the running of the home. The manager was aware of the need to update herself with practice issues and was already compiling a list of training needs for herself. The written aims and objectives of the home were being implemented. Standard 39 Whilst feedback is evidently received from both service users in respect of the running of the home via weekly and recorded service users’ meetings, the manager has yet to devise an annual survey, this is understandable, given the short period that the home has been operational and the manager stated that this would be implemented as soon as practicable. Opportunities are readily available for professionals to communicate their views given the regularity of contact with service users, the manager state that she intends to introduce an annual survey, similarly, for involved professionals. Standard 42 Records indicated that all gas, fire and electrical systems and equipment in the home are serviced and inspected appropriately and that all internal checks are conducted at appropriate intervals. Environmental health and fire inspections had also been conducted in the recent past and no concerns were identified. A number of areas were picked at random and checked against the pre inspection questionnaire, this information provided, was found to have been accurately recorded. Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 23 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 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Homeleigh Residential Care Home DS0000066459.V326599.R01.S.doc Version 5.2 Page 24 N/A 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. Standard Regulation Requirement Timescale for action 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 YA23 Good Practice Recommendations All staff would benefit from updated training in adult protection. 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