Inspection on 17/02/06 for Medora Road, 67

This inspection was carried out on 17th February 2006.

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 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

Medora Road, 67 23/11/06

Medora Road, 67 18/10/05

Medora Road, 67 17/02/05

Medora Road, 67 18/11/04

Medora Road, 67 31/03/04

Medora Road, 67 20/01/04

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

CARE HOME ADULTS 18-65 Medora Road, 67 67 Medora Road Brixton Hill London SW2 2LW Lead Inspector Barbara Ryan Unannounced Inspection 17th February 2006 10:00 DS0000022742.V275775.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 DS0000022742.V275775.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. DS0000022742.V275775.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Medora Road, 67 Address 67 Medora Road Brixton Hill London SW2 2LW 020 8678 6645 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) Southside Partnership Mr D Ebrahim Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places DS0000022742.V275775.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2005 Brief Description of the Service: Medora Road is a residential service for five adults with mental health problems. It is one of a number of homes where the care is provided by a voluntary organisation called Southside Partnership, which provides housing and support services to adults with learning disabilities and mental health problems. The building is owned and maintained by Hexagon Housing Association. Medora Road is a few minutes walk from local shops and buses and a short bus ride away from a busy shopping centre with full community and transport facilities. The ground floor has the lounge/diner, kitchen, 2 bedrooms, a bathroom with toilet and the utility room. The first floor has a toilet, a bathroom with toilet and three bedrooms. The office is on the top floor. There is a small garden at the rear of the house, accessed from the kitchen, and there is unrestricted street parking at the front of the house. Staff liaise closely with the mental health services by use of person centred planning to enable service users to sustain a positive self-image and good mental health. DS0000022742.V275775.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection on 17 February 2006, it began at 9.40am and ended at 4.30pm. The manager and one member of staff were spoken to, 2 care plans/case files were looked at; there was a tour of the building; 3 residents were spoken to and a staff handover was observed. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000022742.V275775.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000022742.V275775.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,5 The home has a policy of only admitting residents after a full assessment with residents having an opportunity to stay at the home over a weekend prior to admission. All resident are given a written contract when they come to the home. EVIDENCE: The managing organisation’s policy is that residents have licensee contracts. Two residents’ files were inspected and both had contracts on file. There have been no new admissions since the last inspection. Southside Partnership have a policy of assessing all prospective residents, they will also have opportunities to spend a weekend at the home prior to admission. The company has a service users guide that gives information about the home and what it offers prospective residents. DS0000022742.V275775.R01.S.doc Version 5.1 Page 8 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 Residents’ care plans reflect their changing needs; residents are encouraged and supported to make their own decisions. Staff are aware of residents’ limits with regard to engaging in activities outside the home and supporting residents whose lifestyle may be detrimental to their health without infringing their freedom or being judgmental in their approach. Risks are assessed and residents are supported around these areas. EVIDENCE: Two care plans were seen; these were comprehensive and clearly written. Residents have monthly meeting with their key worker and identify changing needs and new goals. Care plans are fully reviewed once a year and Care Programmes Approach meetings are held. Resident’s files also have a cultural needs assessment and a life plan. These are completed with residents; whilst residents are encouraged to complete these, there were sections that some residents did not feel able to complete at that time and these sections had been left blank for the time being. All residents care plans are discussed at the monthly team meeting and evaluated. Daily reports were clearly written and signed by staff. Residents are encouraged to manage their own lives and work towards increasing their independence. Residents are encouraged to manage their own DS0000022742.V275775.R01.S.doc Version 5.1 Page 9 money, shop and cook for themselves. All but one resident manages their own money. One resident chooses to go out very little; they are encouraged to the extent that they are able to cope with this, but supported to find other means of managing their affairs from the premises of the home. Staff work with a community psychiatric nurse who visits the home and are exploring other means of providing support within the home. Resident’s lifestyles and freedom of choice are at times in conflict with their wellbeing and staff work with residents to support them around harm reduction and exploring other options. In situations where these plans have not proved successful, staff have re-looked are how best to support the resident and explore other ways of engaging them in maintaining their health and wellbeing. Risk assessments were on the files looked at. These were clear and comprehensive, with clear guidelines for staff of how to work with residents around the risks identified. DS0000022742.V275775.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): 12,13,14,17, Residents are able to undertake culturally appropriate activities and access local community facilities. Residents are supported to maintain a healthy diet, in line with their own choices. EVIDENCE: Residents are being supported to undertake educational, leisure and social activities. They use the local facilities such and local cafes, shops, pubs and cinema. Some residents have quite full weeks with numerous outside activities. Other residents, who have difficulties accessing facilities outside the home due to mental health issues, are encouraged and supported to the extent that they are able to. One resident is engaged in teaching literacy and other attended the local college to improve their own maths and literacy. Residents’ lifestyles, wishes and needs are varied and staff respond in supporting residents around their individual needs and the level of support they need to increase their independence and achieve their goals. The home supports residents to interact with each other in a helpful and supportive way in line with their choices. DS0000022742.V275775.R01.S.doc Version 5.1 Page 11 Residents are supported to recognise that their lifestyle choices need to be tempered to ensure the quality of life of other residents at the home is not reduced; this is done in a sensitive manner. Residents have a weekly programme of activities that they draw up with their key worker and a have a copy of this. Residents mainly cook and shop for themselves, but staff will support people if they are finding things difficult. Residents quite often eat out and staff will try to monitor what residents have eaten but this is not always possible; there is information about healthy eating at the home and support and advice to have a healthy diet are offered. Residents who are not eating or causing staff concern with regard to their diet are supported by staff to maintain as healthy a diet as possible. Residents were observed to use the kitchen freely and prepare food of their own choice. DS0000022742.V275775.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): 18,19,21. Residents are supported around issues of health and personal care to a level appropriate to their needs. Residents are supported to access other health care professionals. The home’s assessment contains information about residents’ wishes around death and religious observance at that time if they have wished to specify them. EVIDENCE: There are issues for some residents around issues of self-neglect; staff are supporting residents to maintain their physical health and personal hygiene with sensitivity. Residents whose physical health has become an issue are being supported to access medical services. When a difficulty arose around accessing support from other professionals, the manager of the home has written and sent the letter recorded delivery when the situation became increasing concerning. Staff are supporting one resident around finding clothes that will fit and try to make clothes shopping an enjoyable day out. Staff liaise with other professionals e.g. CPN’s around how best to meet residents’ needs, and support residents to cope with the temporary changes in accessing health services that a residents have found difficult to cope with. Issues of aging and death are addressed in the cultural needs assessment that is completed with the residents and the wishes are recorded. One resident has DS0000022742.V275775.R01.S.doc Version 5.1 Page 13 recently been bereaved of a parent and staff offered support around attending the funeral or other options such as sending flowers but also allowed them to make their own decision about how they would respond to the event. DS0000022742.V275775.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): 22,23 Residents’ views are listened to and acted on; there is a clear and accessible complaints procedure and residents are protected for abuse, neglect or selfharm. Residents are supported to manage their money appropriately and their choices are respected. EVIDENCE: Southside Partnerships has a complaints policy. There was information about this displayed in the hallway and further details in the sitting room. There was a printed letter for residents to complete. Information is also included in the service users guide residents get prior to admission. Of the three residents spoken to, two said they had no complaints and but would speak to staff if they had. Another resident was not sure, but had on file a letter of complaint they had written and had been supported to use the complaints procedure. Information about the quality manager has been updated and displayed in the hallway of the home. All but one resident manages their own money. Issues around residents’ choosing to give other residents money to shop for them are monitored; an agreement signed by one resident has been and placed on file, as staff had some concerns. The issue was gone through with the resident, but their wishes respected. The resident that staff hold money for is able to access this every day and will ask staff. The money is counted at each staff handover. DS0000022742.V275775.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, 26 30 The home is comfortable, pleasantly furnished and provides a safe environment; residents rooms are individually and personally furnished. The home is clean and hygienic. EVIDENCE: The home has a communal living room, kitchen, utility room, shared bathroom and wc’s and a garden. There is a wide screen TV, DVD and freeview box in the sitting room. There is a large unit in the sitting room that has a fish tank, books and information about the complaints policy, healthy eating and other general information as well as minutes from the residents meeting. There is a modern leather 3 piece suite with homely but modern ornamentation and various pot plants. The garden was accessible and pleasant, with spring flowers blooming near the kitchen door. Residents are responsible for maintaining their rooms, but supported if they need any help. Two residents’ rooms were seen and they were individually furnished and personal to the resident. All the residents have keys to their room and to the front door. There has been an ongoing issue around smoking in the living room. An extractor fan has been fitted, but is not working, and the home is awaiting the DS0000022742.V275775.R01.S.doc Version 5.1 Page 16 housing association returning to deal with this. At present they are relying on an air purifier. All the residents of the home smoke, and for safety reasons residents must not smoke in their bedrooms. The living room is also the only means of accessing the kitchen. The home manager has been exploring this and it has been a topic of regular discussion residents meetings. Various options are being explored about how best to deal with this issue for example looking at building a shelter in a the garden, or if a vacancy arose to whether the home could have a smoking room. The home was clean and hygienic. Residents are supported to take some responsibility with regard to cleaning the home; staff will support residents in cleaning and maintaining level of cleanliness. DS0000022742.V275775.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): 32,34 Residents are supported by an appropriately trained and supervised staff. The managing organisation has an effective recruitment policy that involves residents in the recruitment of staff. EVIDENCE: Staff were observed to be approachable, with good communication skills, and interacted with residents in a relaxed and approachable manner. A staff handover was observed, it gave all the information the worker coming on shift would need with details of each resident’s day so far recounted, any concerns or issues that may arise and things the new worker might need to undertake. This was done in a very sympathetic and professional manner. Southside Partnership has a comprehensive recruitment policy; all applications are sent the their central office. The organisation has been exploring how to involve residents in the recruitment process. Two of the residents at the home have been involved in drawing up questions for perspective workers to be asked at interview, and drawing up acceptable responses. There is a plan in the future for residents to meet prospective candidates and have some direct contact with candidate in the recruitment process. Residents are paid a fee for their input into the recruitment procedures. The managing organisation has competence-based tests for staff and regular training; the home offers supervision every six weeks. New staff have a probationary period that may be extended after the initial period if it felt DS0000022742.V275775.R01.S.doc Version 5.1 Page 18 necessary. At present the home have one staff vacancy; they use bank workers to make up their staff complement. The staff member spoken to said they felt well supported, had regular supervision, that they had been on training and felt part of the team, although they were not a permanent member of staff. DS0000022742.V275775.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): 38,41, 42 The home’s ethos is supported by effective management. The home maintains well-ordered records; it maintains appropriate health and safety procedures. EVIDENCE: The management style at the home creates an open, positive and inclusive atmosphere, where residents changing needs are addressed and their wishes respected. The residents spoken to were all very positive about the level of support they received from staff and said that they were happy at the home and felt that staff did all they could to support them; there was a very relaxed and caring atmosphere in the home. The home’s record keeping is clear and up to date. The home have an on-call book that gives all the information a staff member would need to manage their shift. There were details of all emergency numbers, where water mains are and how to turn off all utilities if needed. There was also clear and quickly accessible information about each resident; this gave their general description, contact networks and information about warning signs regarding any deterioration in their mental health. DS0000022742.V275775.R01.S.doc Version 5.1 Page 20 The home has procedure in place around heath and safely issues; the fridge and freezer temperature are regularly monitored and recorded. All hazardous substances are locked away. Residents are supported to clean the home, but must ask staff if they need to use hazardous substances and staff will ensure they are locked away after use. The home has fire procedures on display and the fire alarm is checked weekly and signed. DS0000022742.V275775.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 3 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 3 ENVIRONMENT Standard No Score 24 4 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 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 X 3 X X 3 3 X DS0000022742.V275775.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action 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 YA24 Good Practice Recommendations The registered manager should continue to work with issues around smoking and how best to provide access to a smoking area, but also provide a smoke free area for residents and staff. The fault with the extractor fan is repaired as soon as possible. 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