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Inspection on 05/10/05 for Orient St Adult Respite Unit

Also see our care home review for Orient St Adult Respite Unit for more information

This inspection was carried out on 5th October 2005.

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 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users know that staff understand what they need, and keep them safe. Service users know staff well, and that if they are unhappy they can complain and will be taken seriously. When they go to the home for a break, service users know they can go out in the evenings, socialise, and do some of the things they enjoy.

What has improved since the last inspection?

Someone visits the home every month now to check that service users are OK, and to sort any problems out quickly. A new alarm system has been fitted so that service users know they can get help quickly in bathrooms and toilets, and in their rooms at night.

What the care home could do better:

Plans for the future of the home need to include work that was done recently to look at the financing and running of the home. Plans for individual service users need to say what service users want to achieve, and how they will be helped to do this. This might include taking more responsibility for their own medication, and the home need to write down how they will do this. Although staff know service users well, the assessments that should be done before the service is first used are not at the home. These are needed so the home knows that they are giving service users all the help they need.

CARE HOME ADULTS 18-65 Orient St Adult Respite Unit 19 Orient Street Kennington London SE11 4SR Lead Inspector Mark Stroud Unannounced Inspection 5th October 2005 02:20 DS0000032035.V252756.R01.S.doc Version 5.0 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 DS0000032035.V252756.R01.S.doc Version 5.0 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. DS0000032035.V252756.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Orient St Adult Respite Unit Address 19 Orient Street Kennington London SE11 4SR 020 7582 5907 020-7582-5344 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) Southwark Social Services Mrs Wendy Jean Palmer Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000032035.V252756.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th March 2005 Brief Description of the Service: Orient Street Respite Unit is run by Southwark Council to provide a short-term respite care service to a maximum of four adults with learning disabilities. The home is situated in a quiet cul-de-sac in Kennington, within walking distance from the shopping centre with leisure facilities and close to public transport routes to central and South London. The home has a car park in which visitors may park and it is used for the home’s minibus. Otherwise parking is restricted in Orient Street. The building houses a respite care unit for children as well as for the one for adults and the children’s unit is the subject of a separate inspection. A central administration area separates the units and a garden to the rear of the building is shared between the adults and children’s units. There are four single bedrooms – two on the ground floor, two on the first floor. Also on the ground floor of the adults’ unit are a large kitchen, a dining room, a living room, a games room, bath and shower room and a WC. DS0000032035.V252756.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An inspector visited the home in the afternoon and spoke to staff and service users. 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. DS0000032035.V252756.R01.S.doc Version 5.0 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 DS0000032035.V252756.R01.S.doc Version 5.0 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 Service users needs are assessed, but not clearly by a professional form the authority that arranged for them to stay at the home. EVIDENCE: Service users do not have a copy of their Community Care Assessment in their files. There are other assessments by Speech and Language Therapists, Schools, and day centres. These can provide good information. DS0000032035.V252756.R01.S.doc Version 5.0 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 Service users are happy staff know what they need but this isn’t written down clearly. EVIDENCE: Adults and their relatives complete plans with staff. Plans talk about peoples culture, religion and ethnicity, how they like to communicate with people, how they say when they are angry, and what they are interested in doing. The plans are not so good at saying when things should happen by, and who will help. The manager of the home knows that plans are important, because it’s easy to forget what people are doing when they only come once every six weeks. When plans are reviewed this doesn’t always involve a social worker from the authority that arranged for service users to live at the home. Staff try to make sure everyone knows what’s happening by visiting day centres and other places services users go. They use this information to try and make sure they work with service users on things that are important to them. Some things that are talked about at reviews and written down don’t say what needs to happen and when. The home work write down the things that worry them, and try to think of things they can do to make service users safer, and for people to worry less. DS0000032035.V252756.R01.S.doc Version 5.0 Page 9 The things that service users already do to keep themselves safe aren’t always written down, and the things that are written down aren’t easy to understand, and don’t tell you exactly what to do, why, and when. This is important so service users have agreed, and know what to expect, and can disagree. DS0000032035.V252756.R01.S.doc Version 5.0 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, 15, 16 & 17 Service users can meet friends and socialise when they come to the home, knowing their family are happy. EVIDENCE: The home try to work with other people who are important to service users, including their family, and people who work in day services. Service users go out in the evenings to pubs, and clubs to dance and socialise. Sometimes they have to come home earlier than they want to because staff have to finish work for the day. The manager said that the home have looked at getting groups of service users together to think about living together more independently away from their families. The home talk to parents and other relatives and friends a lot so that they know what’s happening, and the home know what they need to do. Service users like the food, and are happy they can cook and prepare snacks when they want to. DS0000032035.V252756.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20 Service users know the home look after their health well, but need to be able to take on more responsibility for their medication when they are able to. EVIDENCE: For service users with epilepsy, they are not able to use the home so often because the new alarms that keep them safe at night are not working properly. Service users get help from health professionals so they can say what they want and understand other people better, are able to move around the home more easily, and get help when they feel they can’t cope. Staff are trained to help service users with their medication safely. There are always two staff helping with medication, and staff keep a note of how much medication is taken and how much is left. This helps if there is a mistake made, so staff know how to put things right. One service user knew a lot about their medication, the colour of pills, when they take them and why. Unfortunately, if service users normally take their medication on their own, or want to try and do this, they aren’t able to at the moment. DS0000032035.V252756.R01.S.doc Version 5.0 Page 12 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 Service users know their complaints are taken seriously, and, where they can, the home put things right. EVIDENCE: Service users know how to complain, and do complain when they need to. They are happy that the home does what needs to be done when they complain. DS0000032035.V252756.R01.S.doc Version 5.0 Page 13 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): 30 Service users know they can keep the home and themselves clean and healthy. EVIDENCE: The home was clean and tidy. There is soap and towels to make sure everyone keeps their hands clean to try to stop infection. Service users can use the washing machines. DS0000032035.V252756.R01.S.doc Version 5.0 Page 14 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): 31 & 32 Service users know staff are confident and know what to do, and feel close to them. EVIDENCE: Staff feel well supported in the day, and at night. Staff know each other well and work as a team. Four of the staff are qualified social workers. Other staff are doing a National Vocational Award in care to Level 3. Staff are calm and confident, and are positive when they talk to service users. When staff talk it is to plan to help service users. Staff meet regularly with the manager, and talk about how to help service users better. One of the staff is from an agency but they know the service users well and work at the home regularly. One service user said that ‘staff are like family’. The manager has been asked to make sure job descriptions say staff work with adults and children, and this needs to be discussed with human resources to consider how this can be done with employees and their representatives. Staff records are kept at another office, and will be looked at later. The manager said that all staff have an up to date police check (CRB enhanced), and no new staff have come to the home since September 2004. The next report will say what was found. DS0000032035.V252756.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42, 43 Service users know that staff help them to stay safe. There are plans for the home but these need to be clearer, including how the home will be run in the future. EVIDENCE: Someone who understands how homes should be run visits the home every month, and writes a report. This helps the home to put any problems right quickly. If staff are hurt at work by service users it is written down what they should do. Staff and service users practice regularly what to do if there is a fire. The fire alarm has been tested every week for the last three months. The manager has asked someone to arrange for the electrical wiring and equipment in the home to be checked so that it is safe. One staff member is responsible for making sure staff know what to do if dangerous products like bleach and cleaners are spilled, or hurt staff or service users. They are getting up to date information about all the products used at the home. Portable appliances like TV’s and radios have been checked to make sure they are safe to use. A new alarm system has been fitted, so that service users can get help if needed in the toilets and bathrooms. Staff write down the temperature of DS0000032035.V252756.R01.S.doc Version 5.0 Page 16 food regularly to make sure it is safe. The home has a plan for the coming year, but this doesn’t talk about the finance for the home, and previous plans to ask another organisation to run the homeREQ43. DS0000032035.V252756.R01.S.doc Version 5.0 Page 17 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 2 x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 2 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 2 DS0000032035.V252756.R01.S.doc Version 5.0 Page 18 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 YA2 Regulation 14 Requirement Timescale for action 31/03/06 2 YA6 15 3 YA20 13(2) 12(2) 12(5) 4 YA31 The Registered Person must ensure that the home has a full assessment by a competent person for each service user, normally a Community Care Assessment completed by a social worker from the authority that arranged for the service user to live at the home. The Registered Person must 31/03/06 ensure that Service User Plans are written down saying what service users want to achieve showing this is agreed, who will help, and when it should be done. The registered manager must 31/03/06 ensure that the medication policy includes a planned selfadministration programme. The registered persons must 31/03/06 contact Human Resources and work with them to produce a clearly defined job description, which makes reference to the different service user groups who use the unit. This has been restated from the previous inspection reports. The timescale for action was 30th DS0000032035.V252756.R01.S.doc Version 5.0 Page 19 5 YA43 25(2) April 2004, 30th August 2004, and 30th July 2005. The Registered manager has indicated that action continues to be taken to comply, but enforcement may be considered if this Requirement is not met. The registered persons must 31/03/06 supply a copy of the business and financial plan for the home to the CSCI in order for this standard to be examined. This has been restated from the previous two inspection reports. Enforcement action may be considered if this Requirement is not met. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations The Registered Person should ensure that staff are familiar with the recording of Person Centred Planning, and how this is done in partnership with service users, and promote this within the home by sharing best practice between staff, and with other partner agencies and champions. The Registered Person should ensure that risk assessments start by saying what service users do to keep themselves safe, then what staff can do to help, saying clearly what service users can expect, in what circumstances, and how things will be done. The Registered Person should ensure that staff shifts are flexible and focused on the needs of service users, including where support is provided away from the home. 2 YA9 3 YA14 DS0000032035.V252756.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 DS0000032035.V252756.R01.S.doc Version 5.0 Page 21 - 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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