Inspection on 19/05/05 for Park View (Streatham)

This inspection was carried out on 19th May 2005.

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

The inspector 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 27 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park View (Streatham) 22/08/07

Park View (Streatham) 16/05/06

Park View (Streatham) 03/11/05

Park View (Streatham) 13/01/05

Park View (Streatham) 13/10/04

Park View (Streatham) 11/02/04

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

CARE HOME ADULTS 18-65 Park View (Streatham) 17 Streatham Common South Streatham London SW16 3BU Lead Inspector Sonia McKay Unannounced 19 May 2005, 8:00 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. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Park View (Streatham) Address 17 Streatham Common South London SW16 3BU 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) 020 8679 2364 Crown Wise Limited Mr Allen Amuaku CRH care home PC care home only 18 Category(ies) of MD mental disorder registration, with number MD(E) mental disorder of places Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Up to two persons only aged 65 years and above Date of last inspection 13th January 2005 Brief Description of the Service: Park View is an 18 bed home for adults with mental health needs. It is one of three homes in the locality owned by the same proprietor. The home is in a residential street overlooking Streatham Common within walking distance of Streatham High Road with good transport and other facilities. It was taken over by the current proprietor six years ago and has been extensively modernised and upgraded. Generally the home is decorated and furnished to a high standard.The majority of service users have been at the home for many years. The home provides them with the various degrees of support that they need with activities of daily living. Where appropriate, the home also helps to prepare service users for more independent living, although it is recognised that for most of the service users, this may not be feasible due to the extent of their mental health support needs. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 1.45pm. It took place over five hours during a weekday afternoon. The inspector spoke to three service users and joined a group of service users for the evening meal. The inspector also spoke to the home manager, examined records and viewed the communal areas of the home and garden. Progress has been made in meeting the requirements of the previous inspection report, but further work is required to ensure that all are fully met. What the service does well: What has improved since the last inspection? What they could do better: Care planning processes and associated records must be more detailed and centred on the needs and aspirations of individual service users. The opportunity to attend routine health checks must also be developed for all service users. Although service users have been consulted about their views of the home they must also receive feedback about their involvement. Bedroom arrangements are not ideal as six service users have to share three of the bedrooms and some service users would benefit from moving out of shared bedrooms. Some areas of record keeping must be improved and staff roles must be better defined. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.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. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.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 Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.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, 4 & 5. Service users individual aspirations and needs had been assessed prior to moving into the home. The home was able to meet the needs and aspirations of the service user most recently admitted and had also provided an opportunity for pre-admission visits and a ‘test drive’ of the service before the suitability of the placement was confirmed. Contracts must be agreed and signed as part of placement planning, this had not been done for the most recently admitted person. EVIDENCE: One new service user has moved into the service in January 2005. The service user confirmed that she had been given the opportunity to visit the home before moving in. As the new service user had moved from another home in the area she was also pleased that she was able to continue with her existing work placement and stay in an area that she knew well. The home manager had obtained a copy of the minutes of a recent CPA (Care Programme Approach) review meeting that contain a brief summary of care needs during the referral process. The home manager was working closely with the service user’s CPN (Community Psychiatric Nurse) and keystaff from the home will be attending future CPA review meetings with the service user. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 9 The suitability of the placement has since been reviewed with the service user and deemed appropriate. The staff team have attended additional training in supporting service users with schizophrenia, challenging behaviour and in cultural awareness, ethnicity and communications, with the intention of providing them with the required skills to deliver the care that the home offers to provide to service users. The format of the contracts between the home and the service users have been amended to include the number of the bedroom to be occupied under the agreement, as required in the previous inspection report. However, the new service user did not have a signed copy of the contract and existing service users did not have the amended contracts in place. (See requirement 1). Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 & 9. The homes enables service users to take risks as part of their independent lifestyles. However, the assessed and changing needs of service users are not adequately documented in their individual care plans. Service users are able to make decisions about their lives, but there is a lack of planning for informed decisions to be made by service users who require assistance to make decisions. Financial accounting on their behalf must also be better documented. EVIDENCE: Service users each have an allocated key-worker who has responsibility to meet with the user on a weekly basis. The purpose of the meeting is to keep up-to-date on current issues, to check general wellbeing and healthcare and make any appointments necessary and to check on practical matters, such as clothing needs. The keyworker writes a monthly progress summary and this is reviewed and signed off by the registered manager. Service users spoken to confirmed that they met with their keyworker regularly and found the meetings useful. The meeting records do not have a Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 11 format that links to the service users identified needs and care plan objectives and are not generally signed by the service user. (See recommendation 1). Although care plans identified objectives, action to be taken to meet these objectives are not clearly identified. Care plans are not sufficiently detailed, and do not accurately reflect the needs of the service users (e.g. the care plan of a service user identified that he does not communicate verbally but contained no information on the forms of communication that he uses instead). The most recently admitted service user does not have a care plan in place. (See requirement 2). The majority of service users are able to make decisions about their lives, and are able to manage their own finances, for which they sign for on a weekly basis. One in particular needs considerable assistance, especially in regard making choices and managing his finances. There are no communication aids available to assist the service user to make choices and communicate any decisions to staff. (See requirement 3). One service user requires full support to manage his finances, which are held by staff for safekeeping. Examination of the cash log indicated that two members of staff sign for each expenditure and purchase receipts are also maintained, but there is little detail as to the reason for the expenditure. (See requirement 4). The staff had facilitated service user group house meetings on a regular basis. Service users commented that these meetings were a useful way of deciding about group activities and were an opportunity to discuss other house issues. Records of the matters discussed in these meetings are kept. Service users have also recently completed ‘user satisfaction’ questionnaires, although they have not yet received any feedback. (See requirement 5). Individual plans contain a general risk assessment tool. Based on the outcomes of the general risk assessment tool, individual procedures are developed for service users who are likely to cause harm to themselves or others and are linked to CPA review decisions if appropriate. Photographs of service users are not available in all cases, this would be of great use in the unfortunate event of someone going missing. (See requirement 6). Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 & 17. Service users are able to take part in age and peer appropriate activities and they are part of their local community. A range of leisure opportunities are provided but this does not include an annual holiday. Service users enjoy the meals that are provided which are freshly prepared, varied and healthy. EVIDENCE: Two service users spoken to were involved in employment on a regular basis. Both were happy with their jobs and had been doing them for a number of years, one had continued the supported employment she was involved with in a previous home. The registered provider assists service users with state benefit issues as the needs arises. Some service users are reluctant to participate in structured or organised activities and are able to make their own arrangements for seeing friends and going out, others need support and encouragement to do so. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 13 On the day of the inspection some service user were going out alone to shop and see people and others were going out with staff support. Staffing levels had been increased to ensure that a member of staff is available to assist service users to access the community and a people carrier vehicle has been purchased to provide transport to places of interest. This extra staff support is timed to include evenings and weekends. Where appropriate, service users have Freedom Passes for use on public transport. One service user spoke favourably of the new Saturday party nights that had been arranged in one of the communal areas, when some of the service users from a neighbouring home, Streatham Common South, come round and listen to music, eat food, dance and have a raffle, with those service users from Parkview who wish to join in. Annual holidays for service users are not routinely arranged. As service users have lived in the home for many years in some cases there is a real need to ensure that they have the opportunity of a real leisure break. Discussion with the home manager indicated that contracts with placing authorities did not extend to the funding of seven day breaks and instead the home had funded daytrips. (See requirement 7). Two communal areas are available, one smoking and one non-smoking, both have a televison available. Television signal reception is poor in some areas. (See recommendation 2). The homes policy and procedure for admitting visitors to the home has been revised to ensure that staff confirm with the service user that a visitor should be admitted to the home before letting them enter the premises. The installation of a security camera front door entry system has provided an additional safeguard. Service users are able to entertain their visitors in their own bedroom or in the communal areas. Service users commented that they are able to maintain friendships and relationships with family and friends whilst living in the home. The inspector joined service users in the communal dining room for an evening meal of jacket potato, cheese and freshly prepared coleslaw. Ice cream was available for dessert. A cook prepares all of the main meals and service users are able to see whats written on the daily menu board and if they do not want to have the main item they can tell the cook and have something else prepared instead. The dining room is arranged with several small dining tables. The mealtime was relaxed, with service users coming in as they arrived home and requesting their meal at a serving hatch into the small kitchen. Service users commented that the food is good and that they enjoy the meals. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 14 The record of meals served was examined and provided evidence that a varied range of meals had been served. However, it was not clear what arrangements were in place for service users to be involved in the planning, serving and prepation of meals. (See recommendation 3). The home had been subject to a food hygiene inspection in October 2004 and was making good progress in meeting the requirements made in that report. The home manager was completing a hazard analysis and the temperature of hot food was being checked and a record kept of the results. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20. Service users receive personal support in the way they prefer and require. Their specialst healthcare needs are met. Medication is being handled safely. There is a need to check that service users have access to routine healthchecks and screening. EVIDENCE: Care files examined indicated the degree of personal support that each individual requires with personal care. Most required no assistance at all but one required full assistance with bathing. The format for recording the health appointments made for each service user and the outcome of the appointment has been revised as required in the previous inspection report. Individual records are now in place. These records are stored in a communal folder and should be kept in individual care files with care planning documentation. (See recommendation 4). Examination of a service users health record indicated that he has not seen a dentist, chirpodist or optician in the last year. (See requirement 8). Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 16 He has seen his GP and has had an annual flu jab, he has also seen relevant health specialists treating and monitoring his primary physical illness. Another service user has regular neurology appointments. Service users also have access to the local mental health community team and a regular CPN (Community Psychiatric Nurse) who frequently visits service users living in the home. The home has revised the medication policy and procedure in accordance with current good practice guidance provided by the CSCI pharmacist, as required in the previous inspection report. Twelve members of staff who administer medication have undertaken to complete accredited training in the safe administration of medicines. Photographs of each service user and allergy information has been added to the medication administration record of each service user, assisted with taking their medication by staff. A self medication risk assessment has been completed for a recently admitted service user and a lockable storage space provided in her bedroom to store the medication in. A stock check of controlled drug stock against the quantity of drugs recorded in the controlled drugs book tallied and the home manager was observed to take time to check medications being delivered by the local pharmacist. Medication records examined were completed correctly without any gaps in the recordings. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23. Service users feel their views are listened to and acted on. Steps have been taken to ensure that staff are equipped to protect service users from abuse, neglect and self harm. EVIDENCE: The home has a clear and effective complaints procedure. Service users commented that they are aware of how to make a complaint and feel comfortable to do so. A record of all complaints made by service users is maintained in a log book, detailing the action taken as a result and the timescales. There has been three complaints made by service users since the last inspection visit in January 2005. The complaints were about the behaviour of other service users. One complaint had resulted in meetings with the service users involved and their CPN, and the home manager, a plan of action was developed as a result, and the dynamics between them was still being monitored. Another complaint was revoked by the complainant, and the final complaint was under investigation at the time of the inspection. There has been an adult protection issue in the home within the last year. The complaint was found to be unsubstantiated but resulted in a number of actions. These actions relate to the care of a service user who is unable to communicate verbally and include a need to revise the service users care plan, to better account for his finances, to ensure access to routine physical health checks and to provide staff with specific training. (See requirements 2, 3, 4 & 8). Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 18 The Lambeth Adult Protection co-ordinator provided the whole staff team with training in adult abuse and protection in January 2005 and will visit the home on a three monthly basis to monitor the situation. The staff have also attended training in the specific condition and needs of the service user concerned. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 19 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, 25, 26, 27, 28, 29 & 30. Service users live in a reasonably homely and safe environment. Bedrooms are personalised but shared in some cases, which is not ideal. Toilets and bathrooms offer sufficient privacy and meet the needs of individuals using them. Shared spaces complement and supplement service users individual rooms and the home is clean and hygenic. Hot water temperatures are too low and must be adjusted. EVIDENCE: The homes location offers good access to local amenities, public transport and relevant health services. The home is indistinguishable as a care home and is visually in-keeping with other houses in the area. The home was clean and free from offensive odours on the day of the inspection visit. The home has taken action to address the requirements made in the previous inspection report. Radiator temperature controls in bedrooms are now functioning, radiators and hot pipes are covered in high risk areas ( i.e the room of a service with epilepsy). The front door is now self closing and a security entry system installed to provide additional home security. Requirements made by the fire authorities in November 2004 have been Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 20 addressed and hot water outlets have been thermostatically regulated to prevent scalding. Window opening restrictors have been repaired. The hot water temperatures are checked by staff on a weekly basis and a log maintained of the results. The log was examined and the temperature of hot water was noted to be too low in some areas of the home indicating that the thermostatic valves may need adjustment. (See requirement 9). There are twelve single bedrooms and three shared bedrooms. This is acceptable as the home opened before the standard for single occupancy rooms was introduced. However, some of the service users sharing a bedroom had not made a positive choice to do so and in some cases they did not get along with each other, it is therefore essential that service users have the option of moving to a single bedroom should one become available. (See requirement 10). The home manager had made progress in auditing the furnishings and fittings available in each bedroom against the list of items available in the national minimum standards for bedrooms, as required in the previous inspection report. (See requirement 11). Service users commented that they are happy with their bedrooms in most cases, although one service user found the cigarette smoke drifting from other bedrooms in his area of the home particularly unpleasant. (See recommendation 5). Bathrooms and toilets are sufficient in number, nicely decorated and clean. There are two communal lounges, one for people who wish to smoke cigarettes and another one for non-smokers and a communal dining room, both lounges have roof verandas that service users can sit out on in good weather. The home also has a small paved garden with seating. The laundry room and food store are located in the basement. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34 & 35. The home has made good progress with training plans. Staffing levels have been reviewed and increased to facilitate activities, but further work is required to identify one to one staffing levels for one service user. Team meetings have not been held with the required frequency. EVIDENCE: Staff roles and responsibilities are not clarified and the home manager is still in the process of reviewing the job descriptions. (See requirement 12). 50 of the home staff have undertaken the required NVQ level 2 qualification and seven are taking the NVQ level 3. Eleven staff have received first aid training and there is a first aid trained staff member on duty at all times. Training has been provided in supporting service users with mental health issues and challenging behaviour. Staff must also be trained in supporting service users with epilepsy. (See requirement 13). Staffing levels have been reviewed as required in the previous inspection report. An additional member of staff has been appointed to support service users with activities in the community as a result of that review. There are Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 22 between two and four staff on duty during the day time and two staff on duty at night, one awake and another asleep but on premises should the need arise. One service user requires one to one staff support and it is not clear how that staff member is identified, and as two staff are on duty during some periods of the day, this leaves only one member of staff available to meet the support needs of seventeen other service users. (See requirement 14). Meeting minutes examined indicated that only one staff meeting had been held in 2005. (See requirement 15). The home manager has completed an audit of staff recruitment records. The audit indicates that each member of staff has the required documents on file to verify their identity, qualifications, references and health and criminal records self disclosures. Enhanced CRB (criminal records checks) disclosure numbers are also detailed. POVA First checks (protection of vulnerable adults) have been completed for two newly appointed staff as a safeguard until their full criminal record disclosure is processed. These documents will be checked during the next inspection visit. As staff records are held in the head office, rather than the home itself, it would be useful to keep individual record audit sheets available in the home with a staff photograph attached, then as a new member of staff is recruited a single sheet could be added to the records maintained in the home. (See recommendation 6). The home has made good progress with staff training. Fire safety and food hygiene training has been provided and a training and development plan covering a range of topics has been devised and the training booked for the coming year. The planned training covered empowerment, medication, supervision and appraisal, CPA and risk assessment, confidentiality and record keeping, confusion and its management, the management of aggression and prevention of violence, understanding personality disorder, health and safety awareness, bipolar disorder, communication, the Mental Health Act and motivation. These are all subjects relevant to the needs of the service users. The progress of the training plan will be examined during the next inspection visit. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 23 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, 40, 41 & 42. The home is well run and the home manager is competent. Service users benefit from the ongoing revision of the homes policies and procedures. Record keeping is generally good but must be complete in all areas to safeguard the service users rights and best interests. The health, safety and welfare of service users is promoted by systematic environmental safety checks. The CSCI has not been notified of all events affecting the safety of service users, but these events had been documented appropriately. EVIDENCE: The registered manager is competent, experienced and has a medical qualification, he is supported by a newly appointed deputy manager. He has not yet enrolled to complete the required management and NVQ qualification or investigated whether his current qualifications are equivalent in any way. (See requirement 16). Progress was being made with reviewing the homes policies and procedures, as required in previous inspection reports. The home has a comprehensive set Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 24 of policies and procedures available to provide staff with the necessary guidance in how to deliver care and support and what to do in a crisis. These documents are being reviewed during management meetings at a rate of two at each meeting to ensure that they are applicable and in accordance with any updates in good practice. (See requirement 17). Home and service user records were well organised and stored securely in the staff office. A selection of records examined during the inspection visit included :Records of care needs assessment, planning and care provided to service users (see requirements 2, 3 & 6). Monthly monitoring reports of the checks made on the home by the home owner. These reports had also been sent to the CSCI on a regular basis. A personnel/recruitment records audit. Duty rota’s for staff. Costed accommodation contracts between the service users and the home. The Complaints Log, which contained four new entries. The Accident book, which had been completed as required. Medication administration records. The visitors book, which was well used. The record of meals served in the home. Team and service user house meeting minutes. Financial accounts for one service user (see requirement 4). Fire evacuation drill records which indicate that drills are coducted with the required frequency. Fire equipment testing records. Fire evacuation procedures. The record of incidents. The record of incidents examined indicated that an incident had occurred that the CSCI should have been notified about. (see requirement 18). Small electrical appliances had been safety tested in October 2004. The mains electrical supply had been safety tested in October 2004 and the certificate covers a three year period. The two gas boilers and cooker had been safety checked in April 2005. Employers liability insurance is in place and is valid until January 2006. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 25 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 3 2 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 2 2 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 2 3 x 3 Standard No 31 32 33 34 35 36 Score 2 2 2 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Park View (Streatham) Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x 2 2 2 x G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 26 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 YA5 Regulation 12(5)(a) Requirement Timescale for action 12/08/05 2. YA6, YA23 & YA41 15, 17 & Sch3. The registered person must ensure that each service user has a written and costed contract of terms and conditions between the home and the service user. The contract must contain a copy of the service users care plan and the care plan review arrangements. The contract must be signed by the service user and the registered manager and must be completed for all prospective service users as part of the admission process. Service users already in situ must be provided with amended contracts identifying the bedroom that they occupy under the agreement. The registered person must 26/08/05 ensure that each service user has a detailed care plan, describing the services and facilities to be provided by the home, and how these services will meet the current and changing needs and aspirations and achieve goals. The plan must cover all areas of personal and social support, healthcare Version 1.30 Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Page 27 3. YA7, YA23 & YA41 12 4. YA7, YA23 & YA41 17, & Sch 4 5. YA8 12 6. YA9 & YA41 17 & Sch 3 7. YA14 12 & 13 8. YA19 & YA23 12 & 13 9. YA24 & YA27 12 & 23 and the development of any one to one communication support. The registered person must ensure that staff provide service users with the information, assistance and communication support they need to make decisions about their lives. The registered person must ensure that accurate and detailed financial records are maintained for all transactions made on behalf of service users who need support to manage their financial affairs. This must include a written record of the nature of the items purchased in addition to the purchase receipt. The registered person must ensure that service users receive feedback about the outcomes of their involvement and participation (service users satisfaction questionnaires had been completed). The registered person must ensure that a photograph of each service user is maintained in the individual records of each person. The registered person must ensure that service users in long term placements have, as part of the basic contract price, the option of a minimum seven-day annual holiday outside the home, which they help to choose and plan. The registered person must ensure that service users are offered routine health checks (i.e dentist, optician , chirpodist, well-man and well-woman). The registered person must ensure that all bathrooms and toilets (including en-suite facilities and bedroom hand washing basins) meet the 30/08/05 12/08/05 25/08/05 25/08/05 28/10/05 30/09/05 30/09/05 Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 28 10. YA25 12(4) 11. YA26 23 & 16 12. YA31 18 13. YA32 18 14. YA33 18 15. YA33 18 assessed needs of the service users accommodated. Temperature of hot water must be restricted to within safe limits (i.e. a temperature close to 43 degrees Celsius). Water temperatures were too low in some areas of the home. The registered person must offer the option of moving to single bedroom accommodation to service users sharing a bedroom as and when single bedrooms become available. The registered person must ensure that an audit of furnishings in service users bedrooms is completed against the list in NMS 26.2. Items identified as being unavailable must be made available or a record kept of why an item was not supplied. Previous requirement. Unmet timescale: 11/03/05 The registered person must confirm that job description reviews are complete. Copies of which must be sent to the CSCI Southwark office. Previous requirement. Unmet timescale: 25/03/05 The registered person must ensure that staff are trained in supporting people with epilepsy. Previous requirement. Unmet timescale: 18/03/05 The registered person must review staffing levels to ensure that there are a sufficient number of staff on duty to meet the assessed support needs of the service users accommodated (one service user requires one to one staff support). The registered person must ensure that a minimum of six staff meetings are held in a year. 30/09/05 30/09/05 30/09/05 30/09/05 16/09/05 26/08/05 Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 29 16. YA37 18 17. YA40 12, 13 & 18(4) 18. YA42 37 The registered person must ensure that the registered home manager undertakes appropriate training in NVQ level 4 and the Registered Managers Award, or equivalent courses. Previous requirement. Timescale: 31/12/05 . The registered person must ensure that policies and procedures appropriate to the setting are developed and reviewed on a regular basis. A list is available in Appendix 2 of the National Minimum Standards. Confirmation that all policies are in place and have been reviewed must be sent to the CSCI Southwark office. Progress has been made in meeting this previous requirement. The registered person must give notice to the Commission without delay of the occurrence of any event in the care home which adversely affects the well being or safety of any service user. Any notification made in accordance with this regulation that is given orally must be confirmed in writing. Previous requirement. Unmet timescale: 28/01/05 . 31/12/05 25/11/05 29/07/05 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 devise a format for key work/service user meetings, that encompasses the identified needs and care plan objectives and also involves the service user, evidenced by their signature of G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 30 Park View (Streatham) 2. 3. 4. 5. YA14 YA17 YA19 YA26 6. YA34 agreement where possible. The registered person should provide exterior aerial television reception to improve television reception quality in the communal areas and bedrooms. The registered person should take steps to involve service users in the planning, preparation and serving of meals. Records of healthcare should be maintained in the service users individual care file. Service users who do not smoke should be offered bedrooms in a no smoking area of the home (cigarette smoke escaping from some bedrooms into small enclosed hallways is drifting into the bedroom of a non smoker). The registered person should compile individual staff recruitment recruitment record and checks audits to be kept in the home, along with a photograph of each staff member. Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 31 Commission for Social Care Inspection 46 Loman Street London 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 Park View (Streatham) G52-G02 S22747 ParkView V228522 190505 Stage 4.doc Version 1.30 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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