Inspection on 31/01/06 for Longdown Road (9)

This inspection was carried out on 31st January 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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longdown Road (9) 05/10/06

Longdown Road (9) 09/08/05

Longdown Road (9) 15/12/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Longdown Road (9) 9 Longdown Road Epsom Surrey KT17 3PT Lead Inspector Susan McBriarty Unannounced Inspection 31st January 2006 09:15 Longdown Road (9) DS0000060921.V276170.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 Longdown Road (9) DS0000060921.V276170.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. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Longdown Road (9) Address 9 Longdown Road Epsom Surrey KT17 3PT 01372 748 153 0208 544 8901 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) CMG Homes Ltd Mrs Denise Rush Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2005 Brief Description of the Service: 9 Longdown Road has been opened since September 2004. The house was converted from a hotel into a residential home for up to nine residents. The service is owned by Care Management Group and provides accommodation for 9 residents with learning disabilities. The home comprises of two large lounges, one open plan into the dining area. A large fully fitted kitchen with access to the patio area, which has been decked, and a well-maintained secluded garden to the rear of the house. A therapy/sensory room on the first floor is furnished to meet the needs of the residents. There is a visitor’s room/interview room on the second floor as well as a staff room with en-suite facilities. All bedrooms are single occupancy and have en-suite facilities. There are a number of toilets and bathrooms available throughout the home. The ground floor has two bedrooms and six bedrooms on the first floor and one bedroom and sitting room on the second floor. There is no mechanical access to the first and second floor so all residents must be physically able to use the stairs. There is ample parking at the front of the building. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second for 2005-2006. Starting at 9.15am and taking 4.25 hours. During the inspection a brief tour of the home took place; number of documents were sampled including policies and procedures, a specific care plan, training information and the requirements from the inspection of the previous inspection. The majority of residents are non-verbal and those that could discuss their views of the home chose not to. The Commission for Social Care Inspection wish to thank the home’s staff and residents for making the inspector welcome and assisting with the inspection process. What the service does well: What has improved since the last inspection? What they could do better: The organisations policies and procedures require work to ensure they are up to date and contain accurate and factual information. For example various policies noted the Commission for Social Care Inspection (CSCI) as being ‘the Commission’, NCSC or The Social Services Inspectorate. These are inaccurate and additionally not all the policies noted the local address giving a London address instead. The training policy was unclear and stated that particular training provision was mandatory and this was not necessarily the case. For example training in autism was not deemed suitable by the manager of this home but was considered mandatory by the organisation. The environment offered some concerns as the decking to the rear of the home offered a trip and fall hazard. There were no railings in place to reduce this risk although the CSCI were informed that the provision of railings had been agreed. The body of this report offers further information regarding environmental factors that require addressing and or risk assessing. Please see the end of this report for full details of the requirements made. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longdown Road (9) DS0000060921.V276170.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 Longdown Road (9) DS0000060921.V276170.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): EVIDENCE: Standards 2 and 5 were assessed during the inspection of the 9th August 2005. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 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): 8 The residents of the home have complex needs and the majority are not able to offer their views regarding the day-to-day running of the home or operational issues involving the organisation. EVIDENCE: On the day of the inspection the residents were observed negotiating or making clear to staff there needs and wishes through other means of communication. Requests were responded to calmly and with respect. Longdown Road (9) DS0000060921.V276170.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): 12,14,16 The home provides a variety of activities that meet the needs of the residents. EVIDENCE: The residents of the home have complex needs and the majority are unable to access employment opportunities whether paid or unpaid. The group is also ageing and this too has an impact on their ability to take full part in community life. The residents of the home did not take a holiday during 2005. The manager stated that they were concerned that the residents would become anxious about leaving the home they had recently moved into. The home does however plan to provide a holiday during 2006. Activities are provided internally and externally to the home. For example one specialist organisation attends the home to work with residents and some residents attend the local day centre regularly. The weekly activities for each resident were written on a marker board in the dining area. Family contact varies to each resident and the manager reported that support is provided to try and ensure that family members, where possible, are given Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 11 information regarding their family member. Some residents continue to receive regular contact with their families and those specific residents welcomed this. Observations made during the inspection and discussion with the manager confirmed that residents are treated with dignity and respect. Where a resident was able to voice their views and feelings to the CSCI they chose not to. Due to the assessed needs of the residents not all were able to choose when or where they wished to be and required physical assistance to move around the home. As noted previously the residents are ageing and consideration needs to be given to their changing needs within the home. A requirement is made to ensure that the home has a procedure for working with an ageing group of residents. Some of these issues are highlighted in the environment section of this report. Longdown Road (9) DS0000060921.V276170.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): 19,21 The home was able to meet the healthcare needs of the residents however further work was required to ensure that the needs of the residents who were ageing could continue to be met within the home. EVIDENCE: In discussion with the manager, observations of activities during the inspection and records sampled evidenced that the healthcare needs of residents were met. The healthcare needs of the residents ranged from access to the local community mental health team to admission to a local hospital. Annual health checks are due shortly and are carried out by the General Practitioner known to the home. The residents of the home are not able to meet their own health needs without support. Members of staff would need to be present during consultations to ensure that any information exchanged could be acted upon. The organisation had a policy of dealing with the death of a resident and a copy was available within the home. The staff team had not received training in the changing needs of ageing residents. The manager stated that a plan was in place and that training was Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 13 expected to take place shortly. Given the needs of the residents a requirement is made to ensure that the Commission for Social Care Inspection are informed of the date of the planned training. Longdown Road (9) DS0000060921.V276170.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): 23 Further work is required to ensure that the organisations policies and procedures meet the local policies and procedures regarding the protection of vulnerable adults. EVIDENCE: The organisation provided an internal training course on the protection of vulnerable adults to members of staff. A few members of staff remain who have not had the appropriate training. It could not be confirmed that the internal training course was based on the local multi-agency policies and procedures. A requirement is made to ensure that all members of staff receive training in this critical area and that it is based on the local multi-agency policies and procedures in order to ensure members of staff are clear about the action they are required to take in the event of an allegation of abuse. The organisations policy and procedure does not fully reflect the local policies and procedures in place. For example the procedure does not make clear that the home must refer matters of concern to the local Adults and Community Care for a decision to investigate. The policy requires staff to report to the purchasing or placing authority and had not been updated since 2002. A requirement is made to ensure that the organisations policy and procedure is reviewed and revised to meet the local policies and procedures. The organisations policy and procedure regarding whistle blowing also requires review and updating. For example the policy does not note the need to raise issues such as bad practice. A requirement is made that the policy and procedure is reviewed and updated accordingly. Longdown Road (9) DS0000060921.V276170.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 Whilst Standard 24 was not inspected in full during the inspection of the 31st January 2006 issues are raised in relation to the health and safety needs of the residents. EVIDENCE: During the inspection of the 9th August 2005 it was suggested that railings be provided to the edge of the decking at the rear of the house. The manager confirmed that the matter had been accepted by the organisation and that work was expected to take place. However a date was not available and the drop to the garden from the edge of the decking is a trip and fall hazard. A requirement is made that this matter be dealt with in a timely fashion in order to safeguard the residents. Consideration is being given by the organisation to the installation of a lift shaft to enable the bedrooms of the first and second floors to continue to be used as the residents need change. On the day of the inspection it was observed that a resident was leaving the building on their hands and knees. Whilst this was the preferred option of the resident the CSCI were concerned for their well being as they had to negotiate Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 16 three concrete steps. A requirement is made that the provision of a ramp to the front entrance be risk assessed and the outcome provided to the CSCI. One ceiling in the home was stained following a leak and a requirement is made that the area be made good. One of the home’s tumble dryers had broken down leaving one remaining to ensure that residents clothing could be dried appropriately. The manager was concerned that the remaining machine might overheat when is use, this as its use had grown considerably being the only one available. The door to the utility area was being propped open and a fire extinguisher was kept in close proximity when the tumble dryer was in use. The CSCI were informed that a new larger tumble dryer was due to be installed. A requirement is made to ensure that this work is completed in a timely fashion and ensure that the fire door does not require propping open during use. Window restrictors had been fitted as required during the inspection of the 9th August 2005. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 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): 32,33 The organisation had policies in place regarding the training of members of staff, further work is required to ensure clarity and thereby appropriate training for all members of staff. EVIDENCE: The residents of the home were all white British persons of both sexes. The staff team were multi-cultural and mainly female with only one male member of staff working within the home. The organisations training policy required review and updating as it was found to be confusing. For example mandatory training from the organisation’s policy included management of aggression and an experiential learning workshop. Some examples of mandatory training had not been provided and others were not felt by the manager to be appropriate to this specific home. The policy requires updating to ensure that the organisation notes what is mandatory for all staff and what may be required dependent on the assessed needs of residents within specific homes. The home had a training plan and not all members of staff had completed all the training required. A requirement is made that the training plan include specialist training as required by the home, clear mandatory training provision and agreement as to the dates for refresher courses. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 18 The requirement made during the last inspection: - staff to receive adequate training to meet the needs of the residents including specialist needs had not been met. All the support staff working at the home had recently signed up to undertake the National Vocational Qualification (NVQ) Level 2. The deputy manager was doing the NVQ Level 4 as part of the managers’ qualification. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 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): 39,40 The organisation had begun to work on quality assurance processes and policies and procedures were in place regarding the running of the home and specific ones for staff and residents. Further work is required to ensure that these areas take into account the needs of the residents, members of staff and local policies and procedures provided by the local authority. EVIDENCE: The organisation was reported as beginning to brief home managers on a quality audit programme. The manager stated that the information was due to arrive during February 2006. This process will enable the organisation to gain evidence of the standard of service offered to their service users. A requirement is made to ensure the organisation inform the CSCI of the expected timescale of the first quality audit to be undertaken by the organisation. A number of policies and procedures were sampled and had not been reviewed since 2002. This had implications regarding the information contained in some of those policies as in some instances the law may have changed and in others Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 20 had not kept pace with changes in local procedures; for example the protection of vulnerable adults. In addition those sampled variously described the Commission for Social Care Inspection as the NCSC, Social Services Inspectorate or a registration body. These inaccuracies require amendment. A requirement is made that the organisation review all the policies and procedures and ensure that accurate and factual information is provided. The home does not have access to a computer, such access would enable the home to provide typed documents such as risk assessments and care plans as well as other information that is required as part of the day to day management of a care home. A recommendation is made that the organisation reviews the provision of a computer to the home. The home had completed a considerable part of an evacuation plan in the event of a fire. However on sampling the outcomes of recent fire drills it was evident that one or more service users might refuse to leave the premises. The evacuation plan must include risk assessments regarding individual service users and consideration given to consultation with the Fire Safety Officer regarding outcomes of those risk assessments. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 X 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X 2 X X 2 2 X X X Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 22 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 YA23 Regulation 13(6) Requirement The registered person must ensure that the organisations policy and procedure regarding the protection of vulnerable adults and whistle blowing is in line with the local multi-agency procedures. All staff including the manager to receive vulnerable adult protection procedure training. The organisation to confirm the content of internal training provided to the CSCI. Timescale of 7th October not met. The registered person must ensure that the area where the leak has occurred is made good and ensure the agreed reprovision of a tumble dryer occurs in a timely fashion. The registered person must review and fully risk assesses the provision of railings to the rear garden and a ramp to the front of the home. All staff to receive adequate training to meet the needs of the residents including specialist training. DS0000060921.V276170.R01.S.doc Timescale for action 24/03/06 2 YA23 18 10/03/06 3 YA24 23 28/02/06 4 YA24 13(4) 17/02/06 5 YA35 18 31/03/06 Longdown Road (9) Version 5.1 Page 23 6 YA37 12,13 7. YA37 17 8 YA42 13 Timescale of 21st October not met. The registered person must 31/03/06 ensure that all the organisations policies and procedures are reviewed and updated. Policies and procedures must be 28/02/06 specific to the home and some to be implemented. Timescale of 21st October not met. An emergency evacuation plan 17/02/06 to be implemented to include individual risk assessments of service users as required. Timescale of 2nd September not met. 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 17 Good Practice Recommendations It is recommended that the organisation review the provision of a computer at the home to assist with compilation of documents and communication with the organisation. Longdown Road (9) DS0000060921.V276170.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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