Inspection on 12/12/07 for Longley Road

This inspection was carried out on 12th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longley Road 09/02/09

Longley Road 31/10/06

Longley Road 22/02/06

Longley Road 28/02/05

Longley Road 05/08/04

Longley Road 23/02/04

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 Sign - Longley Road 89 Longley Road London SW17 9LD Lead Inspector Louise Phillips Unannounced Inspection 12th December 2007 09:45a Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sign - Longley Road Address 89 Longley Road London SW17 9LD 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) 020 8767 9933 020 8767 9966 Sign The National Society for Mental Health & Deafness Ms Carole Ward Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Mental disorder, excluding of places learning disability or dementia (6), Mental Disorder, excluding learning disability or dementia - over 65 years of age (6), Sensory impairment (6), Sensory Impairment over 65 years of age (6) Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st October 2006 Brief Description of the Service: 89 Longley Road provides accommodation for six adults who have a mental health need and a hearing impairment. All residents have their own flats with bedroom/lounge, kitchen and bathroom. The home also has a communal kitchenette/dining room, lounge and laundry room for the use of residents. The home is situated in a quiet residential area in Tooting and has an attractive, large back garden. It is close to local amenities and public transport links. The property is owned by Wandle Housing Association and operated by Sign, a charitable organisation. The service users and staff communicate by using British Sign Language (BSL). The weekly charge for £1089.90 per week. Additional charges are made for some outings. Residents are made aware of the inspection report at the residents meeting. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day and included a visit to the service by a Regulation Inspector. When we visited we spoke to the people who live and work at the home, the manager and their line manager. We also looked at records, observed what was going on and looked at the environment. A British Sign Language interpreter was present for some of the inspection to assist the inspector when communicating with the residents and staff. As well as the visit we asked the manager to complete a quality selfassessment. What the service does well: What has improved since the last inspection? What they could do better: Findings from this inspection indicate that there is one area where the home could be doing better. This is highlighted in the report and was discussed with the manager during the inspection. This is regarding making improvements to the medication system to ensure medication is given and recorded correctly. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. Potential residents are provided with good information about the home. The assessment process is thorough to ensure that the service is the right place for new residents to move to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service user guide for the home are displayed on the notice board in the home. There is a policy that details the procedure for the assessment and admission of new residents to the service. The assessment for each resident includes looking at all areas of need, insight into their mental health problems and any medication issues. Admissions to the service are planned, taking place through day visits and overnight stays. A care plan is developed for this process and is reviewed after each visit, where the new resident is assessed and their mental state monitored, particularly when interacting with existing residents at the home. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 9 New residents are offered a trial period to ‘test drive’ the home, with this reviewed after a period of time. If this is successful the resident is then given a contract and licence agreement that provides details of their accommodation and rights. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is excellent. The needs of residents are met by through appropriate care planning and support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The support planning for residents is documented in individualised care plans, with the resident involved in identifying their needs and how these can be supported. Two files were looked at during the inspection. The care plans are individualised and identify relevant issues from the assessment process, along with a lot of information about areas particular to the resident, such as medication, independent living and engagement with community activities. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 11 Residents are involved in choosing their care plans and also their keyworker. One resident talked about seeing their keyworker regularly, being involved in their care planning and in the review of this. The care plans are based on the assessed needs of each individual, such as support with diet/nutrition, budgeting, domestic skills, social and mental health needs. Some care plans also detail any issues regarding communication and differing levels of sign language usage. During the inspection the keyworker for one resident described their role in depth, this including supporting the resident with shopping and cooking and one-to-one work. When discussing their role, the keyworker demonstrated a genuine caring commitment to their work and to ensuring that the residents’ needs and wants are met wherever possible. Where there are more specific risks or as a result of an incident, a risk assessment and management plan details the current safety needs of the resident. These include risks such as being support when outside of the home, or vulnerability in certain situations. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. Residents have the opportunity to be involved in activities based around their needs, interests and community living. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection the residents were pursuing their own interests and activities. Staff spoke about how the majority of residents are very independent in their daily lives and support is provided where necessary. The care files contain information about the different activities that residents pursue such as attending a college course, or going to work as a volunteer, attending a deaf club or spending time at the service, carrying out domestic work. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 13 One resident spoke about how they enjoy living at the home, and how they like shopping and cooking with the support of staff. They also said about the art group they attend weekly, and going to the pub a couple of times a week. During the inspection one resident went out to a party at the college where they do cooking and printing. Another resident was out visiting friends. In the summer all the residents went on a holiday to Spain, with the support of staff. Residents have their own flats and also have access to the communal lounge and to in-house activities, which include board games, television and a music system. The residents have keys to the front door of the home and to their own flats. Staff said that residents buy and prepare their own meals, some needing the support of staff with this. Staff said that they try and encourage residents to buy healthy foods, and this is reflected in the care plans for some residents. It was observed that interactions between staff and residents was positive, with a good rapport developed between both parties. Staff use appropriate forms of address when speaking to residents. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. The service is responsive to the healthcare needs of the residents. Improvements need to be made to the medication system. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents are independent when attending to their personal care needs. A record is maintained of all healthcare appointments that residents attend. Records indicate that there are regular reviews of each residents care, with their involvement, and that healthcare issues are dealt with promptly. The medication for two residents was looked at and the information on the Medication Administration Record (MAR) corresponded correctly with that on the medicine chart. Two residents self-medicate and staff administer medication to other residents, with the resident signing to say that they have taken it, with this being observed by staff. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 15 The following discrepancies were found during the inspection: • • • On one incident the resident had signed for an afternoon dose taken, although the tablets were still in the dossett box. On some occasions the MAR chart had the symbol ‘L’, indicating that medication had not been given, though there were no tablets in the dossett boxes for the dates where ‘L’ had been written. The MAR chart had ‘x’ written in on a number of occasions, though there was no indication as to what this symbol means, as it is not listed as a recognised symbol on the sheet. These discrepancies were pointed out to the manager during the inspection. It is required that a weekly audit of medication administration, and checking of MAR charts is commenced to ensure that any discrepancies and errors are identified and managed appropriately. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made as there are systems are in place to reduce risks to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a satisfactory complaints procedure and format for the logging of complaints. The complaint log details that the last complaint received was in March 2006. There are good records of correspondence relating to the investigation of the complaint maintained in the log. Residents spoken to said that if they had any concerns they would talk to their keyworker or the manager. The training records for staff indicate that they have received recent training in the Protection of Vulnerable Adults (POVA). There are also policies and procedures in place regarding abuse awareness and what to do in the event of this. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The environment is welcoming and homely for the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment of the home is appropriate to the needs of the residents who live there. Each resident has their own flat, which they clean and tidy themselves, with the support of staff if necessary. Residents are able to bring in their own furniture if they wish, though this can be provided by the service. One resident showed us their flat. This was personalised and they said that they had chosen the colour that the flat was decorated in. The resident said that they were happy with their flat and that it had everything they needed. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 18 Residents are also able to use the communal lounge and dining areas, as well as the garden to the rear of the home. All areas were observed to be clean and tidy on the day of inspection. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made as staff have appropriate training and relevant recruitment checks are carried out to protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files for two members of staff were looked at and contain the required recruitment information such as references, photo, application form, copy of identification, interview notes and a copy of their contract of employment. All staff starting at the service have a six month period of probationary period, which is reviewed at regular intervals to review the work of the employee and look at training needs. There is ongoing one-to-one staff supervision provided by the manager, where issues such as developmental needs and issues concerning the residents are discussed. One staff member spoke about feeling well supported by the manager and organisation, and that they have regular supervision and staff meetings to Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 20 discuss any issues. They also spoke about having done lots of training that they found relevant to their job. The training records indicate that staff have received recent training in health and safety, infection control, fire safety, and NVQ level 2 in Care. The manager maintains a matrix of all training done by all staff, highlighting any gaps or where refresher training is needed. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. The service is managed well and in the best interests of the residents. Relevant health and safety checks are carried out to maintain the safety of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Feedback from staff is that they feel there is good management at the home and that they are able to be involved in the development and progression of the service. One staff member stated that: “…the manager is very good, userfocussed, and leads by example…”. The manager demonstrates a very competent and professional approach to her work and developing the service to a high standard. She has worked at the Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 22 service for a number of years and has achieved the NVQ level 4 in Management. She also attends regular training to ensure she is up-to-date in areas such as health and safety and medication awareness. Sign has a policy on quality assurance, which details how the views of relevant stakeholders, residents and their representatives are sought. A monthly house meeting is held with the residents, where they can raise any issues of concern, along with the opportunity for issues to be discussed during their keywork sessions. Residents also have regular meetings with an advocate who visits the service. Sign has also implemented a new audit system, which corresponds with the National Minimum Standards for Younger Adults, to enable the organisation to carry out its own internal audits of services on a monthly basis. Health and safety checks at the service are managed well, and there are certificates and records to demonstrate that the fire alarm system, fire equipment, gas safety and electrical checks are all up-to-date. Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 3 X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X X 3 X Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 YA20 Regulation 13(2) Requirement The Registered Persons must introduce a weekly audit of medication administration, and checking of MAR charts to ensure that any discrepancies and errors are identified and managed appropriately. Timescale for action 31/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Sign - Longley Road DS0000010225.V356083.R01.S.doc Version 5.2 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. 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