Inspection on 04/05/05 for Montbelle Road, 88

This inspection was carried out on 4th May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Montbelle Road, 88 22/12/08

Montbelle Road, 88 02/01/07

Montbelle Road, 88 09/11/05

Montbelle Road, 88 04/11/04

Montbelle Road, 88 25/05/04

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 Montbelle 88 Montbelle Road New Eltham SE9 3NY Lead Inspector Sue Grindlay Announced 4 May 2005 00:00 th 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. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Montbelle Address 88 Montbelle Road New Eltham SE9 3NY 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) 0208 851 5999 LINC Vacant CRH 5 Category(ies) of LD 5 registration, with number of places Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4/11/04 Brief Description of the Service: Montbelle is a large, semi-detached house in a quiet residential street in New Eltham. The Home caters for five younger adults with mild to moderate learning disabilities. The residents have their own bedrooms, furnished and decorated to their own tastes, and use of communal facilities that include a lounge/diner, kitchen, laundry room, conservatory (which doubles as a staff office) and a large garden. There is a toilet and bathroom on the first floor, a shower room and toilet and a separate toilet on the ground floor. There is unrestricted parking in the road at the front of the house, and close by are bus routes to Catford, Bromley or Lewisham.Residents are supported to live as independently as possible. There is a Manager, Deputy manager and up to six support workers, and there is 24-hour cover in the Home. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Although this was an Announced Inspection, the notification went astray, so in effect the manager only had a few days notice of the inspection, yet produced all the required information. The inspection was conducted over 5 hours and included a tour of the building. The Manager and two staff members were spoken to and three service users were present for part or all of the inspection. Care plans, policies and documentation was viewed. What the service does well: What has improved since the last inspection? What they could do better: A more determinedly pro-active approach to residents’ racial and cultural needs should be taken. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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 Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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 Residents needs and wishes are taken into account. EVIDENCE: All five residents have lived in the Home for some time, and are an established group who get on well together. They are viewed though as individuals, and Care Plans reflect this individualised approach to their care. Their initial assessment has been reviewed to incorporate changes and progress in their daily lives. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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 standard(s) 6, 7 and 9 Residents know that their needs and wishes are respected. They are helped to make their own decisions and to take appropriate and measured risks in order to live life to the full. EVIDENCE: Two residents’ files were viewed. Both were well-ordered, with a clearly printed recent profile and photograph of the resident at the front of the file. The residents at Montbelle are viewed as individuals and they each have their own goals and wishes. Guidelines and risk assessments were in place for certain situations, and advice was sought appropriately from other professionals such as the psychiatrist or the speech and language therapist. Staff are responsive to changing needs, for example one resident had a few falls over a short period of time, and he was taken to the optician for a check up, and prescribed new glasses. Residents are encouraged to make decisions wherever possible. At least two residents had had input into the colour of the paint on their walls. Residents choose and, with support, cook a meal one day each week. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 10 Independence is promoted where possible. In one case a resident became anxious about travelling, and a staff member went with him once or twice to reassure him and give him back his confidence. This sensitivity to clients’ feelings is amply demonstrated in the records and by talking to staff who understand and subscribe to the Home’s values and ethos. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 11 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) 11, 12, 13, 14, 16 and 17 Residents at Montbelle enjoy a fulfilling and stimulating life. EVIDENCE: Residents at Montbelle are supported with a range of training and employment opportunities. One resident attends classes and two jobs, one paid, and one voluntary. Another resident attended an assertion class, with the result that he has become more assertive! In addition the number of activities undertaken by the residents is astonishing. Tennis, bowling, swimming, horse-riding and art therapy are just a few of the activities enjoyed on a regular basis. One resident enjoys getting a free CD with his newspaper at the weekend and loves to listen to music. In addition all the residents have joined a theatre club for deaf and disabled people and the arts that gives them reduced seat prices. In the Home the range of reading material has been expanded in the living room in line with a previous recommendation. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 12 Residents have polling cards for the impending election but are unlikely to be able to exercise this right, and staff were sensitive to the implications of trying to support this whilst not imposing their views. Meals are eaten together and each resident has a turn of choosing and cooking, with support, a meal each week. One resident had a folder of recipes of things that she had made at a cookery class, and having them in the Home enabled her to practise her skills and consolidate her learning. The menus showed a range of principally English food. The Home does have a Caribbean cookery book, but it seems not to be used very frequently. Considering three of the five residents are black, it would seem more appropriate to offer more culturally appropriate meals on a regular basis, and this is a recommendation. A black member of staff said that she would be prepared to bring ingredients from Catford or Lewisham as they are not obtainable locally. A staff member went out to do the weekly shop on the day of the inspection and a resident accompanied her. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 13 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) 19 Residents’ physical and emotional health needs are well met. EVIDENCE: The health of service users has high importance and the files showed evidence of health checks at regular intervals, and staff supporting residents to attend for various appointments. One resident was pleased to show his new spectacles, which made him look very smart. One resident had a tooth extraction under general anaesthetic just before Christmas, and this was planned carefully following a best interests meeting of all parties. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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 standard(s) 22 and 23 Residents are safe and their welfare is protected. EVIDENCE: There have been no complaints since the last inspection. There is a book for comments by the door, and, when asked by the Manager, all five residents said that they felt safe in the Home and that they knew who to speak to if they were unhappy with their care. The Home has a policy on Adult Protection and staff are aware of measures to safeguard residents and staff. Once again one staff member spoke about knowing the residents so well that, “when something is wrong we would know because of their behaviour”. One newer staff member had done some training in Protection for Vulnerable Adults in her induction but Adult Protection did not appear to be on the list of topics routinely covered by LINC and this is a further recommendation. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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 standard(s) 24, 26, 27, 29 and 30 The Home is a safe, clean and comfortable environment for all the residents to relax and to pursue their individual interests. EVIDENCE: Since the last inspection some minor maintenance issues have been addressed. One resident’s bedroom has been decorated, the glass has been replaced in the door to the conservatory and clear film has been applied to the other panes, kitchen cupboard hinges have been tightened and the bathroom cabinet has been mounted on the wall in the bathroom. A crack has been sealed around the door frame in the bathroom but this now needs repainting, and the Hall way too is showing signs of wear and tear. These are now recommendations. One resident has a new aid on order called a ‘Bath buddy’ and it is to help her in and out of the bath. The Manager said that it would be portable so that she will be able to take it with her when she goes to visit her mother. Two rooms were seen on this visit and both had evidence of personal items. One resident Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 16 had purchased a new television, and was able to sit in bed and watch his favourite programmes. The Home was clean and tidy and things in the kitchen and laundry were wellorganized. A schedule on the inside of the cleaning cupboard said what household tasks had to be done each day by the residents.There was no liquid soap in the downstairs toilet or either bathroom and no soap or paper towels in the laundry. This is a requirement. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34, 35 and 36 Staff are trained and supported well to carry out their duties. EVIDENCE: Staff spoken to one the day of the inspection said they enjoyed their work and spoke of the happy atmosphere in the Home. “One big, happy family” was how one person described the Home. Residents had not been involved in staff recruitment, but one newly appointed member of staff had already worked in the Home as a Bank support worker, and knew the Home well. A male member of staff is leaving and the manager said that they hoped to recruit another man, particularly as they have three male service users. All staff have attended a basic First Aid course and there is regular updating training on Manual Handling, Food Hygiene, Fire Safety and Speech and language Therapy. Speech and language therapists are to offer training to staff on communicating with residents. Two staff members attended a conference in January on Asperger’s syndrome. The manager has asked for training for staff in Sexuality and relationships, and this is entirely appropriate given the age of the residents and issues that present from time to time. All the training provided naturally has a focus on learning disability, but there seems to be no Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 18 specific training around diversity or racial equality, and this is a further recommendation. Supervision is taking place at between six and eight week intervals. A supervision schedule is pinned up on the wall in the office to remind staff when it is due. No records were looked at, but staff confirmed that they receive regular supervision. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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 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, 38, 39, 40, and 42 Residents live in a well-run Home where their safety and welfare is promoted. EVIDENCE: The Manager has now been confirmed in post and must register with the Commission. She has worked in the field of learning disability for many years, and has been at Montbelle since it opened. The Manager has a Certificate in Management Studies and is about to begin her Registered Manager’s Award, NVQ 4 and Assessor’s Award. She and the new Deputy manager work well together and have complementary skills. Registered Provider reports were received at the Commission up until the end of the year. Reports from January and March were available in the Home, and these should be sent to the Commission. This is a requirement. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 20 Policies have been put in order and indexed and they now correlate with the contents page. Safety issues in the Home have been addressed since the last inspection. At the request of the Fire Service, a door has been constructed to the laundry room, and a new bolt fitted to the front door. Lockers for staff personal belongings are now in the conservatory. The emergency lighting is working and a key has been obtained for all fire points. The fire systems were actually being checked whilst the inspection was taking place. A fire drill took place on 25/2/05. It should be noted that the names of all staff and residents who participated should be recorded, and the time the drill took place was also missing in the record. This is a further requirement. Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 x 3 2 Standard No 11 12 13 14 15 16 17 3 4 3 4 x 3 2 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Montbelle Score x 4 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x 4 x G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA30 Regulation 13(3) Requirement Timescale for action Immediate 2. 3. 4. YA37 YA39 YA42 8(2) 26 23(4)(e) There should be liquid soap and a hand towel or paper towels available in toilets and laundry to prevent the spread of infection The Manager must apply to be Immediate registered with the Commission A copy of the Person in Control Immediate visits should be sent to the Commission on a regular basis The Fire Drill record should log Immediate the names of all the staff and residents who participated, and the time the drill took place 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. 2. 3. 4. Refer to Standard YA17 YA23 YA24 YA35 Good Practice Recommendations It is recommended that culturally appropriate meals are preapred for residents on a regular basis It is recommended that updated Adult Protection training be offered to all staff as a matter of course It is recommended that the bathroom and hallway be repainted to conceal the filler and to freshen them up It is recommended that all staff attend training in diversity or racial equality G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 23 Montbelle Montbelle G51G01s6878Montbellev2210474.5.05stage4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverhouse 1 Maidstone Road Sidcup Kent DA14 5RH 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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