Inspection on 10/03/06 for Lewisham Park, 40

This inspection was carried out on 10th March 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lewisham Park, 40 15/02/08

Lewisham Park, 40 01/11/06

Lewisham Park, 40 20/12/05

Lewisham Park, 40 28/02/05

Lewisham Park, 40 12/11/04

Lewisham Park, 40 21/01/04

Lewisham Park, 40 08/10/03

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 Lewisham Park, 40 Lewisham London SE13 6QZ Lead Inspector Barbara Ryan Unannounced Inspection 10 March 2006 09:30 Lewisham Park, 40 DS0000025599.V280858.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 Lewisham Park, 40 DS0000025599.V280858.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. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lewisham Park, 40 Address Lewisham London SE13 6QZ 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 3141877 Mr Percival Fitzroy Drummond Ms Maise Melanie Bell Mr Percival Fitzroy Drummond Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2005 Brief Description of the Service: 40 Lewisham Park is a large property offering residential care for up to 3 residents with learning disabilities. The house is located in a residential area opposite a park, and close to public transport links. The house is spacious and the care is provided by the proprietor and manager and who live in the house with their two children. The house has the appearance of a family home and the residents benefit from this environment. There was one vacancy at the time of the inspection. The two current residents are brothers and have lived at 40 Lewisham Park for a number of years. The residents spend their day in various planned activities such as day care and voluntary work. Their evenings and weekends are spent at home or in leisure pursuits. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 10.03.2006 between 9.30 and 1.15 p.m. There are at present only two residents and both were out at their respective daycentres or other activities. The method of inspection included discussion with the home owners, a tour of the building and inspection of records and other documentation. What the service does well: What has improved since the last inspection? What they could do better: The home needs to continue to work at developing a more comprehensive record of care assessments, care planning and reviewing, that will comply with regulations and include details about lifestyle choices and activities. They need to have a vulnerable adults policy and to attend some up to date training on the protection of vulnerable adults. The home need to complete a Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 6 services users guide and include some information for prospective residents about providing screening or some form of curtaining for people that share a room and the need for a hand washing basin in the room 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. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 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 Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 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): 1,5 The home have produced a statement of purpose. The home needs to produce a services users guide. This needs to include some information about the rooms lack of wash basin and screening and that this would not be seen as suitable for future residents. The home has a contact and is awaiting them being retuned from the funding authority for their two residents. EVIDENCE: 40 Lewisham Park operated for many years as an Adult Placement Scheme, providing care to three residents in a family setting. One of the residents has now left and the remaining two brothers have lived at the home for over seven years. Changes in the needs of the residents and in legislation around care services led to the registration of the owners as providers/managers of a registered care home. The owners have had to make changes in the practise and record keeping in order to comply with registration requirements. The home has a vacancy, however the owners say that they have no plans to fill this vacancy in the future. The home now have a written contract of terms and conditions. They have not asked the residents to sign this as they feel that they do not have the capacity to sign a legal contract and have sent this the Lewisham Partnership, the funding authority to sign and are awaiting this being returned. The contract has information on cost and what is included and what is not included in the fees. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 9 The owners have as required from the last inspection report produced a statement of purpose. This is a substantial document. They have not as yet produces a service users guide. The home should include information about the lack of a wash basin and screening in the residents shared bedroom Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 10 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 The home provide care and support in a non- institutional setting that has an informal and family oriented atmosphere. The residents needs are known by the home owners. Care plans and the way they are reviewed could be developed to include more information about goals and progress as well as how the residents views are included in the reviews. Risk assessments should be completed in more detail. EVIDENCE: The home provide care and support in a family setting, which is noninstitutional and informal in atmosphere. The residents share the home with the owners and their family. The resident’s needs are known by the homeowners. They have care plans for the residents, and these showed evidence of being regularly reviewed. However at the last inspection it was a requirement that the care plans need to be revised to demonstrate that the routines of the home and activities are meeting the individual and changing needs of each resident. They need to show evidence of progress on aims, goals and achieving them as well as how resident’s choices have been incorporated into them. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 11 There is a daily record book for each residents. These record personal care tasks completed in the morning and other events. The home owners had been able to complete a Life History Book for both residents. Information and photos were being provided by the residents family. The homeowners have been able to access the photos and other papers and have completed the books. They report that one of the residents has enjoyed looking at this and going through it. Both residents were out at their respecting activities on the morning of the visit. However discussion with the homeowners showed that residents are supported to make decisions and choices about their lives. The homeowner are aware of the residents needs and how they express their choices and preferences. Risk assessments are on the care plans, these as with other aspect of the care plan could be looked at again, if no changes to these have been identified then this should be recorded on the risk assessment. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 12 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, 13,14,16,17 The residents have opportunities for personal development, links with the local community and access to appropriate leisure activities. They are offered a home cooked diet. EVIDENCE: Both residents have an individual programme of activities that reflect their interests and abilities. These include attending a day centre, voluntary work within the local community, as well are educational and leisure activities. The residents also have established links with local Catholic Church and one of the residents attends mass on a regular basis. The residents have quite individual programmes of activities. The home have supported the residents to live lives to some extent independent of each other during the day, whilst able to return home and spend their evening together. The home owners said that both residents have an advocate, who has known them for many years, he visits them regularly and also takes them out on outings and social visits. At the last inspection it was queried whether a more formal arrangement with an advocate from an agency that specialises in Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 13 advocacy work might be helpful. The situation that gave rise to this suggestion has now changed. The homeowners may wish to explore with the residents, the advocate and the social worker from the funding authority if there is any need to further explore this. The home owners said the residents will take some responsibility for making their bed, collecting laundry, making tea and other household tasks, but need some level of support in these areas. Both residents have holidays booked for this summer, they have liased with the local Mencap branch around this issue. The home owners have a weekly menu for the evening meal, this was varied and all home cooked. There is no menu for breakfast but the home owners know the residents likes and dislikes and ways of expressing choices. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 14 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, 21 The residents receive appropriate personal support and their physical and emotional needs are being met. The residents have been supported around issues of bereavement and ill health. EVIDENCE: The residents are supported around their personal care. The home owners know both residents very well and are familiar with their needs. Neither residents are on any medication at present. Both are able to access the local GP and dentist as needed. The home owners were able to demonstrate that they understood the residents differing emotional needs and how to offer appropriate support to each. The home owners have supported the residents around bereavement in the quite recent past. They supported them to attended mass, the funeral and arranged flowers, and have continued to support the residents afterward. The residents were referred to Lewisham Partnership with regard to whether they needed some level of professional counselling at this time. This was discussed with the homeowner and it was decided by the agency that this was not needed in their view at present. The home owners can go back to the service if they feel the situation changed at some point in the future. The home owners have used the life story book to support one resident around Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 15 issues of medical investigation, and this may be a useful way of working with other health investigation in the future. The home owners have made contact with an organisation that supports people and families around a particular and quite rare complaint and are able to gather information and support and are in doing this further able meet the needs of their residents. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 16 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 The home has a complaints procedure. They do not have a vulnerable adults procedure. They need to have one and receive more up to date training on this. EVIDENCE: The home has a complaints procedure, they have received no complaints. The homeowners were able to explain their complaints procedure and that if the complainant was not satisfied they would be advised to contact the Commission for Social Care Inspection or social services as there are no other people or levels of management involved in the running, or the ownership of the home. The home do no have any policy on the protection for vulnerable adults. One of the owners has been on training but this was some years ago. The home owners were advised that they need to attend training and that they should ensure that they do have a policy on vulnerable adults and they should consult Lewisham Partnership with regard to gathering more information around this. The home have adequate procedures around safeguarding the residents money, as recommended at the last inspection they now have a ledger with a running total. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 2528,30 The residents live in a large pleasantly furnished and decorated Victorian house overlooking a park. They choose to share a bedroom. They have access to all the communal areas of the house including a large garden. The home is clean and hygienic and all the repairs mentioned at the last inspection had been completed. EVIDENCE: The home is situation in a large Victorian house in a crescent overlooking Lewisham Park. The residents have access to all the downstairs rooms and the garden There is a large pleasantly fitted bathroom on the first floor that they share with the rest of the family. The residents share a room on the first floor. There has been an ongoing issue around the lack of a sink unit in the room and the lack of screens to preserve privacy. It has been agreed in the past that whilst this would not be acceptable for other prospective residents, the present situation is unique to the two present residents and for them it is appropriate. The home must ensure that their statement of purpose details this and would not be appropriate for any future residents. The residents room was large and pleasantly furnished, with a TV and two armchairs placed side by side for them to watch TV. Their were numerous personal items around and was a pleasant and homely environment. The Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 18 homeowners said that both will spend time in their room together and enjoy time together to talk and watch TV. The overall impression of the home is that of a family home that offers an very non- institutionalised environment. The home is clean and hygienic and all the repairs mentioned at the last inspection had been completed. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,36 There are no staff employed at the home and there are no records pertaining to supervision or recruitment. The homeowners informally support each other and will contact outside agencies if there is a need for other professional support for the residents. EVIDENCE: The owner of the home employ no staff and provide all the support to residents themselves. As the home employ no staff there are no rota, recorded of employment, recruitment or supervision. One of the owners will always be at home when one or both of the resident are at home. Both owners showed a knowledge and understanding of the needs of the residents. They offer support to each other with regarding to the running of the home. They will, if they need, contact Lewisham Partnership if they feel that the residents need support from other professionals, or that they need advice. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 20 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, 38,41, 43. The home is well managed. It offers care and support within a family setting to residents. The home needs to continue to build on the work already done develop further to ensure they fully meet The Care Home Regulations 2001 and National Minimum Standards for this client group. EVIDENCE: The owners have started an NVQ course and will work through this to level 4. Both said that they are finding the course helpful. The home is well run and both owners were able to demonstrate a positive and committed approach to the residents that they provided care and support to. The ethos of the home is very much that of offering a care service within the setting of a family home. The homeowners have worked hard since the last inspection to ensure that they have all the recording systems, polices and procedure they need in place and have made progress, they need to continue their work to develop these systems. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 21 At the last inspection there was a requirement that the home draw up an annual budget for the home to identifies money being paid into the service and how this is allocated. At present is being completed by the homes accountant. It is within the timescale of 30/06/06 laid down At the last inspection there was a recommendation that the homeowners liaise further with the Commission and Lewisham Social Services to explore whether the home would be more appropriately registered as an adult placement scheme. The homeowners are concerned that if they returned to the adult placement scheme they would not longer be able to offer a home to the present two residents, who originally come to them via the placement scheme. The original reason they needed to register being that the resident’s needs were too high for the placement scheme. This situation may now have changed and the homeowner should continue to explore the situation around adult placement with Lewisham Partnership and the Commission. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 22 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 2 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 x LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 3 3 X X 2 X 2 Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 23 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 YA1 Regulation 4(1,2)5,6 Requirement The registered person must ensure that a service users’ guide is completed and this must detail the current position regarding the non provision of a screen and hand washing basin in the bedroom. The Register Person must develop with each resident an individual care plan that includes information about their aims, goals, information about progress made, as well as how residents choices are incorporated into the care planning process. The registered person must ensure that care plans and records include specific assessment of services users leisure interests and social activities. Still within time scale of 06/06/06 set at last inspection 4 YA 23 13(6) The registered person must ensure that the home has a policy on the protection of vulnerable adults and that at DS0000025599.V280858.R01.S.doc Timescale for action 01/09/06 2 YA6YA41 15 01/08/06 3 YA14 16(2)n 01/06/06 01/09/06 Lewisham Park, 40 Version 5.1 Page 24 5 YA43 25(2)(c) least one of the owners attends up to date training in this. The registered person must draw up an annual budget for the home that identifies money paid into the services and how it is allocated. Still within time scale of 03/06/06 set at last inspection 03/06/06 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 YA38 Good Practice Recommendations The home owners should continue to liaise with Lewisham Social Services and the Commission to explore whether the home would be more appropriately registered as and adult placement scheme. Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 25 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 Lewisham Park, 40 DS0000025599.V280858.R01.S.doc Version 5.1 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!