Inspection on 09/08/05 for Longdown Road (9)

This inspection was carried out on 9th August 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 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

Longdown Road (9) 05/10/06

Longdown Road (9) 31/01/06

Longdown Road (9) 15/12/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

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33 St John`s Church Road

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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 Vera Bulbeck Announced 09 August 2005 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 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 Stationary 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) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Longdown Road (9) Address 9 Longdown Road Epsom Surrey KT17 3PT 01372 7748153 01372 743250 Telephone number Fax number Email 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 The Pointe, 89 Hartfield Road, Wimbledon, London, SW19 3TJ Mrs Denise Rush Care Home (CRH) 9 Category(ies) of Learning disability (LD) 9 registration, with number of places Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15 December 2004 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. There is a therapy/sensory room on the first floor that is furnished to meet the needs of the residents. There is a visitors 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 throughtout 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) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first announced inspection to be undertaken by the Commission for Social Care Inspection year April 2005 to March 2006. Mrs Vera Bulbeck, Lead Inspector for the service, carried out the inspection. There are currently nine residents living in the home and the majority have lived in the home since opening September 2004. The residents were observed and spoken to; communication with one of the residents. Five members of staff were spoken to and all stated the home is operating on an open management style and the staff team including agency workers feel supported and work together as a stable staff team. A full tour of the premises was undertaken. Three care plans and three staff files were inspected. One comment card was received from a relative and comments were very positive. The G.P also made very positive comments in the feedback card regarding the care provided in the home. The inspector would like to thank the manager, staff and residents for their time, assistance and hospitality during the inspection. The service users living in the home prefer to be called residents; therefore the report will use and reflect the word residents. What the service does well: It was pleasing to note the home has a stable staff team who are able to interact with the residents well. It was evident from observation that the residents are comfortable with staff and communication is obtained by a number of methods. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 6 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. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 standard(s) 2 & 5. The home has a detailed and informative statement of purpose and service users’ guide. However, details of the resident with a sensory impairment must be included to ensure the home is able to meet the needs of the resident. These documents, together with the home’s procedure of carrying out detailed assessments and offering a well-structured series of visits prior to admission, enable residents and prospective residents to make an informed choice about admission to the home. The individual written contracts need to be revised to ensure that all relevant information is available. EVIDENCE: The homes statement of purpose needs to be regularly updated and to include any changes to the home and should include relevant information as detailed in The Care Homes Regulations 2001, Schedule 1. Information for prospective residents including the homes service user guide is in picture form and the majority of residents with staff support would be able to understand the content. It was noted that each bedroom had a copy of the service users guide. Three care plans were sampled and it was noted that care plans were informative and detailed. The manager informed the inspector that care plans are continually being updated and changed. However, it was noted in a care plan, a resident had been admitted to the home outside the homes category of registration. The resident is currently on a trial period and is not suitable for Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 9 the home. A placement has been found for the resident and will be moving on 16/08/05 to a more suitable placement, who will be able to meet the residents needs. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 9 & 10. The service users’ individual plans are regularly being changed and are clear and comprehensive including details of needs and goals. They also incorporate known or indicated preferences with in depth risk assessments. EVIDENCE: Plans reflect areas of need; they were found to be up to date and have been regularly reviewed. Entries made gave clear indication of the actual care given. Risk assessments had been completed on residents. However, a fire risk assessment needs to be undertaken on a resident who smokes in her sitting area in the top of the house, and a potential fire hazard. A key worker system is in place and staff have the responsibility of helping residents achieve everyday goals, such as holidays or going shopping. Staff in a Key worker role help residents to arrange social events of their choice also hospital and GP appointments. The residents do not currently have a bank/building society account. The money is held centrally at CMG headquarters and money is paid into CMG account. The inspector was informed there is difficulty in obtaining residents bank accounts, as they do not have a passport or a utility bill in their name. A Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 11 director of CMG is the appointee for the residents. The director involved is pursuing this matter. The inspector advised the home that only small amounts of cash should be held in the home at any time. The inspector spoke with a number of residents and was able to communicate with a small number. The staff have a good understanding of the needs of residents and are able to communicate by means of sign and body language. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 standard(s) 13, 15 & 17. The residents have opportunities for personal development, to take part in appropriate activities within the home and in the local community. They are supported and enabled to maintain and develop appropriate personal and family relationships. Meals are well balanced and varied. Systems are in place to ensure that resident’s rights are respected. EVIDENCE: There was evidence to support that residents are encouraged to be as independent as possible and observation confirmed the staff talk to them and provide support when required. Residents enjoy a number of activities, these include, shopping and swimming. On the day of inspection four residents went for a day trip to Bognor. They had a picnic on the beach and residents confirmed they had enjoyed their day. The registered manager stated because of the changes in the residents lifestyle since moving into Longdown Road and settling in period residents would not be having a holiday this year but several days have been planned for various outings. Some residents prefer to go out on day trips. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 13 The evening meal was observed by the inspector to be served by a member of staff, there was choice of prawn salad, which appeared to be very popular with the residents, or a pasta dish. Some residents are involved with the preparation of the meals. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 standard(s) 18 & 20. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies and practices are in place for the administration and management of medications. EVIDENCE: The medication records observed were found to be well documented and recorded. The home needs to apply for the “Administration and Control of Medicines in Care Homes and Children’s Services” document. Staff administers medication, there are no residents who are able to self medicate. The inspector observed residents to be able to choose their own clothes oneservice user decided she wanted to change her tee shirt and did so. Staff were seen to support residents personal needs and were sensitive to their privacy and dignity. There are designated key workers for the residents and a number of residents have family involvement with their care. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 standard(s) 22 & 23. The majority of policies and procedures are in place however; a complaints policy needs to be implemented to ensure that staff are aware of the correct procedure when dealing with complaints. Policies are in place to protect residents from abuse and neglect but lack of staff training is placing residents at possible risk of harm and abuse. EVIDENCE: Records indicated the home had received two verbal complaints since the last inspection. The registered manager has been dealing with the complaints and has agreed to finalise in writing the outcome of the complaint. The organisation CMG Care Management Group has its own adult protection policy and procedure. However, the home was advised to obtain a copy of Surrey’s multi agency vulnerable adult procedure. The members of staff spoken to on the day of inspection had not received training in this area. All staff must have regular updates to the protection of vulnerable adults procedure training. Staff need to be aware of the policies and procedures and must be aware of the whistle blowing policy. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 standard(s) 24, 26 & 29. The location and layout of the home is suitable for it’s stated purpose. It is accessible, safe and well maintained. The home was found to meet residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 17 The premises were found to be homely and welcoming, and each bedroom was nicely decorated and personalised. A number of aids were available in the home. However, there were some areas that require attention. A number of bedrooms require window restrictors; some were broken and needed replacing and some need to be fitted. The inspector would recommend that the two lounges have restrictors fitted to ensure the safety of all the residents. A glass panel on the top of the stairs was cracked and needs replacing. One resident who smokes has a bedroom at the top of the house with a separate area for smoking. The inspector would highly recommend a fire risk assessment for this area be undertaken. The garden is nicely laid out and well maintained by the staff. On the day of inspection lunch was observed to be in the garden, it would appear from comments made the garden is well used. Even the homes two cats were enjoying lazing in the sun. However, the decking is some distance from the ground and the inspector was advised the home has requested and it has been agreed a rail to be fitted to ensure residents safety from falling. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 18 Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34,35 & 36. All interactions observed between staff and residents evidenced a high degree of respect and skill in working with the individual residents at the home. Staffing is kept under review and provided to meet the needs of the residents at all times. Action must be taken to improve the staff training. EVIDENCE: The management of the home has developed a training programme, which identifys staff training needs at a glance. There are a number of staff that require further training, this includes fire safety, protection of vulnerable adults and food hygiene. Recruitment records were available and found to be well maintained. The manager informed the inspector that supervision on staff had commenced. Staff confirmed when spoken to stated that supervision had been undertaken and on a regular basis at least six times a year. Appraisals need to be undertaken on a yearly basis. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 41 & 42. Resident’s benefit from the management approach at the home providing an open, positive and inclusive atmosphere. The systems for resident’s consultation are varied and have been devised specifically to enable the residents to make their views known. Action must be taken to ensure that staff training promotes and protects the health, safety and welfare of residents. EVIDENCE: Regular meetings with the residents, and minutes of the meeting are held on file. Regular visit by the responsible person are undertaken monthly. A number of records were examined and found to be well documented. Policies and procedures were observed and some were found to be in need of updating, and should be specific to Longdown Road. It was difficult to locate the policies easily in the folder. However, these were attended to on the day of inspection. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 21 An emergency plan needs to be implemented for the home and the fire extinquiiishers need to be tested, as the date of expiry was 07/05. Riddor needs to be notified with regard to a resident who has fractured his Femur. It was also noted that correction fluid had been used on the menu, records are legal documents and correction fluid must not be used. All staff must receive food hygiene training as the majority of staff undertake cooking in the home. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x 3 x Standard No 11 12 13 14 15 16 17 x x 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score 3 x x 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Longdown Road (9) Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x 2 2 x H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 23 No 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. 2. Standard 7 9 Regulation 16 13 Requirement All residents must have their own bank/building society account. A fire risk assessment to be undertaken on a resident who smokes in her own lounge at the top of the house. All staff including the manager to receive vulnerable adult protection procedure training. All Bedrooms to have approprriate window restrictors fitted. The glass panel on the top of the stairs needs replacing. All staff to receive adequate training to meet the needs of the residents including specialist training. Policies and procedures must be specific to the home and some to be implemented. Correction fluid must not be used on records which are legal documents. Serious injuries must be reported to RIDDOR. An emergency evacuation plan to be implemented. Fire extinquishers to be tested on a regular basis. H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Timescale for action 09/11/05 22/08/05 3. 4. 5. 6. 23 24 24 35 18 13 13 18 07/10/05 16/08/05 19/08/05 21/10/05 7. 8. 9. 10. 11. 37 41 42 42 42 17 17 17 13 13 21/10/05 12/08/05 12/08/05 02/09/05 26/08/05 Page 24 Longdown Road (9) Version 1.40 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 24 Good Practice Recommendations The two lounges on the ground floor as a safety precaution to have window restrictors fitted. Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Longdown Road (9) H09-H58 S60921 9 Longdown Road V231860 090805 Stage 4.doc Version 1.40 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. 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