Inspection on 30/12/05 for Repton Road,73

This inspection was carried out on 30th December 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Repton Road,73 13/12/06

Repton Road,73 02/08/05

Repton Road,73 22/03/05

Repton Road,73 16/07/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Rugby House Project

City Roads Crisis Intervention

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

CARE HOME ADULTS 18-65 Repton Road,73 73 Repton Road Orpington Kent BR6 9HT Lead Inspector Wendy Owen Unannounced Inspection 30th December 2005 13:00 Repton Road,73 DS0000006908.V268706.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 Repton Road,73 DS0000006908.V268706.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. Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Repton Road,73 Address 73 Repton Road Orpington Kent BR6 9HT 01689 836661 01689 836661 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) Community Options Limited Ms Emy Nerveza Care Home 5 Category(ies) of Past or present alcohol dependence (5), Past or registration, with number present drug dependence (5), Mental disorder, of places excluding learning disability or dementia (5) Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 Adults with a mental disorder who may also have past or present alcohol or drug dependence 2nd August 2005 Date of last inspection Brief Description of the Service: 73 Repton Road is a large two-storey semi-detached house in a quiet residential area, providing care and accommodation for five adults with mental ill health. This home is part of a group of homes within the community that specialises in residential care for people within the mental ill health category. The home is staffed by a manager and team of support workers providing twenty-four hour care. Service users’ accommodation is on both floors, accessed by steep stairs, making it unsuitable for people with significant mobility difficulties. All bathroom, toilet and bedrooms are fitted with locks that can be accessed from the outside in case of an emergency. Service users have appropriate medical cover on admission and each service user is registered with a GP of their choice whenever possible. They also receive treatment from a range of other health care professionals as required. Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the course of an afternoon. The inspection included discussions with the Manager and support workers, viewing records and monitoring of the requirements and recommendations from the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 Page 6 The medication practices, which required improvement at the last inspection still require improvement. The moving and handling training for some staff requires updating or risk assessments must be developed to determine the frequency of such training. 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. Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: The core standards were fully inspected at the last inspection. There were no requirements raised at that time. Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 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 the following standard(s): 6 The care plans provide staff with information and guidance on the needs of residents to ensure they are provided with the care and support required. EVIDENCE: The requirements from the last inspection were monitored. Care plans have improved with information and guidelines now provided on the holistic needs of the residents, as well as the individual objectives set by the residents. The care plans viewed now indicate other needs, which may well impact on the individual’s mental health and the action the staff should take to address this. The Care Programme Co-ordinator and home regularly review the residents’ needs. Repton Road,73 DS0000006908.V268706.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): 17 EVIDENCE: The core standards were inspected at the last inspection. One requirement raised at this time required the home to record the nutritional needs of residents. This is seen as of particular importance to the individual’s mental health needs. The home now keeps some records of the nutritional intake, although this can be very difficult to achieve when residents spend a good deal of time outside of the home and take their meals and refreshments at this time. The staff understand the individual’s rights of residents but must also balance this with ensuring they are protected when they are at their most vulnerable. Repton Road,73 DS0000006908.V268706.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): 20 Medication procedures require further improvement to ensure residents’ health and well-being is not placed at risk. EVIDENCE: The home records service users’ medication, including photographs of each resident. There is also a record of the medication entering the home. However, there is no record of medication leaving the home, specifically in relation to when residents take medication away with them. The home redispenses medication from the original container for the resident to take with them with no records in place. (See requirement1) The last report also highlighted that the home’s medication administration record did not correspond with the pharmacy label. Two medication records viewed showed that this still continues to be the case. The home must ensure that the home’s record accurately reflects the prescription (and therefore the label). For example one resident was prescribed paroxetine 20mg take two daily. However the medication record stated paroxetine 40mg once a day. (See requirement 1) The home has developed guidelines for each service user to detail the stage of “self-administration” currently arranged, with the expectation that movement to the next stage would also be risk assessed and determined by competency at each stage. The medication prescribed is monitored regularly by the Consultant responsible for the individual’ mental health needs. Repton Road,73 DS0000006908.V268706.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): EVIDENCE: These standards were fully inspected at the last inspection and were met at this time. Repton Road,73 DS0000006908.V268706.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): 24, 28 & 30 The home is reasonably maintained and progress is being made in the redecoration programme to ensure residents have a homely and comfortable place to live. EVIDENCE: The organisation has an action plan in place for the redecoration of the lounges and bathroom, which is to be commenced in the New Year. The kitchen has been repainted, as required by the last inspection and now looks fresh and clean. Whilst a deep clean has not been undertaken, the parts of the home viewed on this occasion were reasonably clean. Repton Road,73 DS0000006908.V268706.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): 33, 35 & 36 Staff are well-trained and have the knowledge and understanding of the residents’ specific needs providing them with a safe place to live and ensuring their needs are met. EVIDENCE: On the day of inspection many service users were away from the home for a number of reasons. Staffing levels remain as per the usual roster with a full compliment of staff. The last inspection required the home to ensure staff rosters identified the role of the support workers to the supported living environment. The roster now highlights the member of staff involved in these tasks and there is a work-plan for the time spent at the location. The last inspection also required core training to be provided within a reasonable time of a new employee commencing employment. There is evidence of induction and foundation training taking place for the new member of staff with more specific training arranged in the New Year. Discussions with staff and viewing of records show that staff are provided with a significant amount of training in relation to the needs of the client group. There have been no new members of staff employed since this the last inspection and therefore the requirements relating to recruitment practices raised at that time could not be fully monitored. Repton Road,73 DS0000006908.V268706.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): 37, 38, 39 & 42 The Manager is experienced and well-organised promoting the health, safety and well-being of residents and staff. The organisation regularly reviews the quality of care in order to continually improve the quality of care for residents. EVIDENCE: The Registered Manager has been in post for a number of years with previous experience as Manager of other homes in the organisation. She is a qualified Registered Mental Health Nurse; has a Certificate in Management and further role related training including a Certificate in Mental Health Law. She is currently undertaking a qualification in Cognitive Analytical Therapy, which she is funding herself. The Manager is motivated and is well organised, providing leadership and guidance to the staff team. Community Options is accredited to Investors in People and has regular audits associated with re-accreditation. The home is also monitored as required under Regulation 26 with a brief report sent to the Commission recording the findings of the visit. The home also undertakes regular health and safety checks which are included in the Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 Page 16 quarterly monitoring reports. These reports form part of the home’s audits and include monitoring of care plans; medication, meetings (residents and staff) and health and safety. Community Options is also part of the Business Excellence quality assurance system which use key performance indicators to assess whether the objectives have been met. These objectives are service user focussed with the key performance indicators reviewed each month. The Manager also stated that an integral part of the reviewing system includes consultation and feedback from residents Moving and handling training remains outstanding for some staff as identified in the last report. The last report recommended risk assessing this activity or ensuring the training takes place. No new training will take place until 2006 and therefore this means some members of staff may be nearing three years before being updated. (See requirement 2) The last report also required fire signs to be in place and this has now been done with further signs to be purchased and placed in appropriate areas to assist fire safety. Repton Road,73 DS0000006908.V268706.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 X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X 3 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Repton Road,73 Score X X X 2 Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 2 x DS0000006908.V268706.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 YA20 Regulation 13 Requirement Timescale for action 01/02/06 2 YA42 13 The Registered Person must ensure that medication procedures promote the safety of residents. Specifically, • all prescribed medication must be labeled with the individuals name; the administration on the pharmacy label must correspond to the administration recorded on the home’s medication record. (This is an outstanding requirement from the last inspectiontimescale has expired) • The home must record all medication leaving the home. Specifically, when residents are taking medication away with them, there must be an accurate recording of the name, amount, dose and date of the medication leaving the home. The Registered Person must 01/02/06 ensure that staff are provided with regular moving and DS0000006908.V268706.R01.S.doc Version 5.0 Repton Road,73 Page 19 handling training. The regularity must be identified in the home’s risk assessment. Please provide the Commission with an action plan for the provision of such training with the relevant risk assessment. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Repton Road,73 DS0000006908.V268706.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup 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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