Inspection on 21/11/05 for La Rosa

This inspection was carried out on 21st November 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 no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

La Rosa 28/08/08

La Rosa 20/08/07

La Rosa 05/07/06

La Rosa 14/03/06

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

CARE HOME ADULTS 18-65 La Rosa La Rosa 97 Babington Road Streatham London SW16 6AN Lead Inspector Sonia McKay Unannounced Inspection 21st November 2005 11:00 La Rosa DS0000065081.V266377.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 La Rosa DS0000065081.V266377.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. La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service La Rosa Address La Rosa 97 Babington Road Streatham London SW16 6AN 020 7787 9694 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) Mrs Parvadee Shumoogam Mr Radhakrisna Sookur Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: La Rosa is a private residential care home that provides 24-hour care and support for three adults with mental illness. The home is situated in a residential area, close to high-street shopping and transport links. The home opened in September 2005. La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the first inspection of La Rosa. The inspection involved talking with the sole service user living in the home, a member of staff, the deputy manager and the registered manager. Records relating to care needs assessment, care planning, health and safety, staffing and the running of the home were examined. There was also a full inspection of the home environment and garden. 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. La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 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 La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 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): 1, 2, 4 & 5. Prospective service users have the information they need to make an informed choice about moving to the home and have opportunity to visit and test drive the service. Prospective users individual aspirations and needs are assessed prior to admission. Each service user has an individual written contract stating the terms and conditions of living in the home. EVIDENCE: There is an informative ‘Statement of Purpose’ and a ‘Service Users’ Guide’ to the home. The home provides long-term placements. There is opportunity for visits and overnight stays. This allows the referred person to experience life in the home before making a positive choice to move in for a trial period. One service user has been admitted to the home. The service user confirmed that he visited the home before making a decision to move in. Care records show that the manager attended review meetings prior to this admission to assess the suitability of the placement. An initial care plan is in place in accordance with the social work review meeting recommendations. A second service user is at the initial stages of visiting the home. The home manager is attending hospital ward rounds to familiarise himself with the La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 8 referred persons care and support needs. Needs assessment information has been obtained and is available. Service users have a contract of service and occupancy. The service user and the registered manager sign the contracts. La Rosa DS0000065081.V266377.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. Individual care plans are comprehensive and regularly reviewed. However, they do not define rehabilitation in sufficient detail. Service users are able to make decisions and take risks as part of an independent lifestyle, within an individually agreed risk management framework. EVIDENCE: The written plan of care for the service user living in the home at the time of the inspection includes the issues identified in a recent social work placement planning meeting. An overall risk assessment and risk management plan is in place. The service user and key worker devised the in-house care plan and both parties have signed it. The plan was reviewed with the service user after one month. The service user said that he is in agreement with the arrangements in place. He is assessed as able to continue to self-medicate and attend day services. La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 10 The social worker placement plan identifies rehabilitation as the placement aim. The in-house care plan does not clearly define an agreed rehabilitation programme. (See requirement 1) La Rosa DS0000065081.V266377.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): 11, 13, 15 & 17. The service user living in the home has the opportunity to continue with personal development and social activities that he engaged in prior to moving into the home. The service user is offered a healthy diet and enjoys the meals prepared. EVIDENCE: Information about local college courses and specialist services is available in the communal lounge. The service user living in the home has been able to continue with activities engaged in prior to entering the home. These activities include attending daytime social groups and skills development sessions. The service user is familiar with the local area and transport links. He visits members of his family on a regular basis and is being encouraged and supported by staff to re-establish other family links. Although there is a four-week rolling menu programme available, as there is only one service user he is given a daily choice of meals. Records are kept of these meals. The records show that a range of meals have been prepared, including culturally appropriate dishes. The service user is La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 12 encouraged to prepare meals with a member of staff. He said that he enjoys the meals in the home. Food shopping is done in bulk by the registered proprietor. It is recommended that service users be involved with shopping for food provisions to develop shopping and budgeting skills and aid rehabilitation. (See recommendation 1). La Rosa DS0000065081.V266377.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): 19 & 20 Steps are being taken to ensure that service users physical and emotional health needs are met. Service users are able to retain, administer and control their own medication where appropriate, and are protected by the homes of policies and procedures for dealing with medicines. Staff must be trained to safely administer medication. EVIDENCE: The service user has registered with a local GP and dentist. Mental health nursing care is provided by a CPN from the local community mental health team. The service user has yet to register with a chiropodist and optician. Health-care plans identify the required frequency of attendance to a range of health care services. There are also regular blood tests to monitor for potential side effects of a prescribed medication. A risk assessment is in place in regard to self-medication. Staff monitor compliance in accordance with the written care plan. A lockable cabinet is available in the service users bedroom to store a weekly supply of tablets. There is a medication policy that includes staff administration of medication and self-medication. La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 14 The registered person must confirm that arrangements are in place to train new staff in the safe administration and handling of medication. (See requirement 4) La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Although there are policies in regard to abuse, neglect and self-harm, failure to complete adequate checks on members of staff does not provide service users with adequate protection from abuse and neglect. EVIDENCE: There is a complaints procedure in place. There have been no complaints made. Procedures are in place for responding to suspicion or evidence of abuse or neglect (including whistle-blowing) to ensure the safety and protection of service users. There are adult protection procedures in place that include dealing with aggression and service users finances held in safekeeping. The home has not obtained enhanced criminal records bureau checks or checks against the POVA (protection of vulnerable adults) list for staff currently employed. Photocopies of checks completed by previous employers are available. These records are incomplete and unsatisfactory. (See requirement 2) La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 30. Service users live in a homely, comfortable and safe environment with bedrooms and bathrooms that meet the modern expectations of service users. Shared spaces complement and supplement service users individual rooms. EVIDENCE: The large home is clean, comfortably furnished and well decorated. All bedrooms are single occupancy and there is a choice of bedrooms available. The ground floor has a sitting room, small staff office, small kitchen, dining/sitting room and access to a back garden. There are toilet facilities and a small laundry area. The first floor has four bedrooms, three with en-suite facilities. There is also a bathroom. The second floor has three bedrooms, two with en-suite facilities and there is an additional bathroom with a shower unit. There is also a staff room. Bathrooms and toilets are fitted with appropriate privacy locks and hot water temperatures are regulated to within safe temperature limits. La Rosa DS0000065081.V266377.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): 33, 34 & 35. Recruitment procedures do not provide service users with adequate protection. The home staff team is not yet complete. Staff training and development needs must be assessed and an appropriate plan devised to ensure that service users are supported by appropriately trained staff. EVIDENCE: Staffing levels reflect the fact that there is only one service user living at the home. One member of staff is on duty with a manager during the daytime and one member of staff is on duty, but asleep, at night. There is a lone- working policy and procedure in place. The homes statement of purpose contains an organisational structure. This shows that one deputy manager; six day carers and four night carers are to be employed. At the time of this inspection there is a full-time deputy manager, one full-time carer and four part-time carers. The majority of staff have been redeployed from other businesses owned by the proprietor. It is essential that the home build a stable, permanent staff team to ensure effective key working and continuity of care. Recruitment records do not include all of the documents required by legislation. For example, references are missing and enhanced criminal record bureau checks including POVA checks are not available. Photocopies of checks conducted by previous employers are available only. La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 18 An immediate requirement was issued on the day of the inspection. (See requirement 2) Staff contracts of employment are not in place in recruitment records. (See requirement 3) Recruitment records contain evidence of training undertaken in previous employment. One part-time member of staff has a National Vocational Qualification in Promoting Independence at level 2. A training needs assessment must be undertaken and a staff training and development plan for 2006 formulated. (See requirement 4) The induction record for one member of staff was examined. The record details a comprehensive in-house induction for working at La Rosa but was incomplete. The home manager facilitated a one-day home induction meeting for all staff currently employed. (See requirement 5) La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 19 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 & 42 The registered home manager is suitably qualified and experienced. There is a need to improve health and safety systems to protect service users and staff. EVIDENCE: The registered home manager has relevant experience and qualifications (RMN/RGN/Dip/SW & CMS). He is currently undertaking a registered managers award (RMA). Health and safety checks include: • Daily COSHH checks • Weekly bedroom checks • Fridge and freezer temperature checks • Hot water temperature checks • Fire alarm call testing A fire evacuation drill has been conducted but the record did not specify the date of the drill or who was evacuated. (See requirement 6) La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 20 A large number of sharp knives are available in the kitchen. There is no risk assessment or record of the number of knives available. (See requirement 7) There are a large number of tins of paint and unlabelled containers of chemicals on a shelf in the garden. (See requirement 8) Many fire doors were propped open during the inspection. There is no fire risk assessment in place. (See requirement 9) The gas boiler was safety tested in November 2005. There is no record of small electrical appliance testing available. (See requirement 10) Employers liability insurance is in place La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X 3 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 1 1 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 La Rosa Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000065081.V266377.R01.S.doc Version 5.0 Page 22 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. 1 Standard YA6 Regulation 15(1) 12(1)(b) Requirement Timescale for action 28/02/06 2 YA23YA34 19 Sch 2 3 YA34 12(5)(a) 18(1)(b) 4 YA20YA35 18(1) The registered persons must develop and agree a rehabilitation programme with service users who have been placed in the home for rehabilitation. The programme plan must describe the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations. The registered persons must 21/11/05 ensure that all staff working in the home have adequate recruitment records in place. Immediate requirement. The registered persons must 28/02/06 ensure that staff working at the home are provided with statements of terms and conditions of employment in place. The registered persons must 31/03/06 ensure that there is a staff training and development programme which meets the Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of DS0000065081.V266377.R01.S.doc Version 5.0 La Rosa Page 23 service users’. 5 YA35 18(1) The registered person must ensure that all staff receive structured induction training (within six weeks of appointment) and foundation training (within six months of appointment) to Sector Skills Council specifications. The registered persons must ensure that the dates that fire evacuation drills are conducted and the names of individuals taking part are recorded. The registered persons must assess the risk posed by keeping a large number of sharp knives in the communal kitchen. The registered persons must ensure that containers of paint and unknown chemicals are removed from the garden and stored securely. The registered persons must ensure that fire doors are not wedged open and conduct a fire risk assessment of the premises (advice must be sought about the laundry room door). The registered persons must confirm that small electrical appliances have been safety tested 31/01/06 6 YA42 17(2) Sch 4 31/01/06 7 YA42 12(1) 13(4) 13(4) 23(2)(o) 31/12/05 8 YA42 31/12/05 9 YA42 12(1) 13(2) 23(4) 31/12/05 10 YA42 23(2)(c) 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA17 Good Practice Recommendations The registered persons should involve service users in shopping for food provisions to promote and develop independent living skills. DS0000065081.V266377.R01.S.doc Version 5.0 Page 24 La Rosa 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 La Rosa DS0000065081.V266377.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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