Inspection on 18/04/05 for Sandford Road,4

This inspection was carried out on 18th April 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 but made no statutory requirements on the home.

Other inspections for this house

Sandford Road,4 09/07/07

Sandford Road,4 25/05/06

Sandford Road,4 24/10/05

Sandford Road,4 30/12/04

Sandford Road,4 14/09/04

Sandford Road,4 31/01/04

Sandford Road,4 13/05/03

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 Sandford Road 4 Sandford Road Bromley Kent BR2 9AW Lead Inspector Rosemary Blenkinsopp Announced 18 April 2005 09.45 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. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Sandford Road Address 4 Sandford Road, Bromley, Kent BR2 AW 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 8313 1017 Community Options Limited Gina Benjamin 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) Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 30/12/04 Brief Description of the Service: Sandford Road is part of the Community Options group of homes. It provides support for five residents in the category of mental disorder including past or present alcohol and drug abuse. The residents in this home are undergoing rehabilitation in order that they may live more independently in the community. The usual length of stay in this facility is two years. Residents in this home are subject to Care Programme Approach( CPA) after care systems. The staff in the home are on site throughout the 24-hour period. The staff team are supported by the manager and her deputy. Senior management is provided through Community Options and on call systems are in place. Multidisciplinary mental health teams are provided through the Primary Care Trust. All other health care is accessed through the community. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted as an announced visit which the home had been notified several weeks in advance. The last unannounced inspection had been conducted 30 December 2004 where a number of issues had been identified requiring action. A tour of the premises was undertaken including communal areas and some bedrooms. The inspector met with residents one a length. The manager facilitated the inspection whilst other staff participated in the inspection process. Four comment cards were received prior to the inspection two from GPs and two from other professionals. The pre inspection documentation was completed. A selection of care plans and records were viewed. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 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 standard(s) 2,3,4,5 Prospective residents are assessed and provided with information relating to their placement, prior to admission. However with the limited facilities in the Borough providing this type of support, choice is limited. EVIDENCE: The previous manager, Mr John Cribbens, who is employed at head office in a management capacity, assesses all prospective residents. The current manager then conducts a further assessment to establish their suitability in the home. Recently two residents had moved into the home and the manager had not conducted an assessment although had met with them prior to their admission. Community Options have a standard assessment tool covering all aspects of health and social care. Overnight stays and visits are encouraged prior to any permanent placement being made. One recently admitted resident had had five visits before any decision on the placement was taken. In addition, information received from the multi disciplinary team and under the Care Programme Approach (CPA) is also obtained. Terms and conditions and service agreements were seen in residents’ files. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 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 standard(s) 6,7,9,10 The care plans and associated risk assessments would not provide enough information to address the resident physical, psychological, social and spiritual needs. EVIDENCE: The care plans in this home are referred to as support plans. The format is resident-focused and comprehensive although completion was patchy. Two support plans were viewed one of a newly admitted resident, the other of a longer-term resident. The information in one support plan indicated selfharm and suicide ideation. The risk assessment was limited in respect of this issue and there was no support plan in respect of suicide ideation. Other risk assessments were in place, although some initial information was missing. The second support plan had limited information in respect of the current behaviour of the resident particularly his non-compliance with medication and spending long periods away from the home. There was limited information in respect of his absences or on his mental health state. The information recorded must be reflective of the residents needs and be updated as required. The support plans included the resident’s objectives, although little thereafter on those areas identified in respect of the interventions to be taken by staff. Please see requirements 1 and 2. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 9 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) 11,12,13,14,15,16,17 The residents are supported to enhance their daily living skills, to maximise their abilities to live independently. Staff promote choice and independence in all aspects of daily living. EVIDENCE: The activities in this home are built around promoting skills for more independent living; this includes involvement in the local community and accessing services. Residents, as part of their rehabilitation, do their own shopping and cooking with staff support. Staff advise residents on healthy eating although ultimately it is their choice. One resident is attending a business course although currently none are in paid employment. Residents’ meetings are conducted covering any issues occurring in the home. Independent advocates can be involved, if appropriate, and the residents request this. Visiting is open and encouraged. Several residents do go home for visits including overnight stays. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 10 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) 19,20 Personal and heath care are appropriate to residents’ needs. The medication systems need to be further developed in respect of policies and storage. EVIDENCE: Currently there are no residents who require assistance with personal care although prompting is sometimes required. All residents access local health care in the community which means attending the GP, dentist etc. Residents attend a hospital appointments using public transport, all can travel independently unaccompanied. Two residents with whom the inspector met confirmed that staff were supportive, encouraged choices and independence. They both confirmed that staff had supported them with developing skills and offered psychological support. One resident stated that she would prefer more women residents; currently she is the only one. The medication systems were inspected. The pharmacy inspector had visited 31/1/2005 following concerns arising form the previous inspection. The medication charts, which were inspected, were found to be incomplete without drug sensitivities recorded. Gaps in records of administered medication were evident on two charts with no reason stated for this. The medication policy needs to be amended to include the recommendations of the pharmacist. There is still no alternative storage for external medication this should be investigated with advice for the pharmacist. Please see requirement 3. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 11 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 The home has appropriate systems in place for raising concerns or complaints. Systems for dealing with finances were suitable for this group of residents. EVIDENCE: Information on complaints is available and residents have several avenues for raising concerns both internally and externally. Residents with whom the inspector met related that they would raise concerns either with staff in the home or their CPN, or care manager. Residents have budgeting included as part of their rehabilitation. Every resident must have bank account so benefits payments can be made directly into the account. Residents are discouraged from leaving money in the home, although there is a balance sheet for recording receipt and expenditure if this should occur. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 12 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) 24,25,28,30 The recent refurbishment has significantly improved the home creating a comfortable and suitable environment for those living in it and those visiting it. EVIDENCE: The home is maintained in a domestic style. All furniture and fittings were comfortable and homely. The kitchen had been replaced and this significantly improves the area. One resident is actively involves in planting and gardening. He showed the inspector what he had achieved so far. He also looks after the fish tank. It is good practice for residents to be involved in the maintenance of their home environment. The radiators are without covers; a general health and safety assessment covers this aspect of risk. This must be kept under review when new residents are admitted, particularly if anyone should suffer from epilepsy or mobility problems. All bedrooms are single. Three bedrooms were viewed, two were clean and tidy the other was quite untidy. Residents are fully mobile, and must be so in this home as there is no equipment available or lift access. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 13 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) 31,32,33,35,36 Staff were knowledgeable and positive about their role. The training that they receive furnishes them with the skills and knowledge to carry out their roles effectively. EVIDENCE: Staff are provided through out the 24-hour period including waking night staff. Staff are recruited through the head office of Community Options. The staff files are retained at the head office. Within the home is a staff information sheet, which details the CRB number, a photograph, the form of identity presented and signatures to confirm these documents, had been checked. One staff member confirmed she had a job description, terms and conditions and that these had been amended and reissued two years ago. She was fully aware of her role and responsibilities and line management arrangements. She confirmed that staff are offered a lot of training internally and externally. Some of the courses included statutory issues whilst others covered mental health and related topics. Training certificates were on site. Some of the statutory training needed re addressing, as they were not up to date and new staff have joined the team. Staff confirmed that formal supervision is provided regularly with an annual appraisal. Please see requirement 4. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 14 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) 37,38,41,42 In general health and safety practices are satisfactory although more robust record keeping needs to be maintained to support this. EVIDENCE: The manager has, since this inspection, been appointed to the permanent position. At the time of the inspection she was in an acting position. The manager has worked in the home for several years. She demonstrated a good knowledge of the residents, mental health issues and the home’s objectives. She felt competent to effectively manage the service to maximise residents’ stay in the home. A selection of health and safety records were viewed and found to be satisfactory. During the tour some doors were wedged open. The fire officer had raised this in addition in his report he referred to the intermescent strips, which had been painted over and this would render them unsafe. There are plans to fit fire door guards on each fire door, which release automatically. Gaps in weekly fire alarm records were also identified. Fire training was conducted although staff should sign to confirm attendance. Please see requirement 5. Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 15 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 N/A 3 Standard No 11 12 13 14 15 Sandford Road 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x x 3 Version 1.20 Page 16 G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 2 x Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 17 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 6 Regulation 15 Requirement The Registered Person must ensure that care plans are comprehensive in content, kept under review and accurately reflect all of the service users needs.The Registered Person must ensure that contingency plans are in place to detect early onset of inappropriate behaviour and appropriate measures put in place to address this.Previous completetion date 31/3/05 The Registered Person must ensure that risk assessments are completed in respect of any identified risks to service users. Previous completeion date 31/3/05 The Registered Person must ensure that all medication procedures and records are robust and comprehensive. All requirements as stated in the Pharmacy report to be met Previous completion date 31/1/05 The Registerd Person must ensure that all stautory training is updated for all staff Timescale for action 30/6/05 2. 9 13 30/6/05 3. 20 13 30/6/05 4. 32 18 30/5/05 Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 18 5. 42 23 The Registered Person must 30/5/05 ensure all health and safety aspects in the home are addressed and records to evidence this are retained on site and available.Previous completion date 31/1/05 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 42 Good Practice Recommendations The Registerd Person should ensure all staff sign on reciept of fire traing Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Sandford Road G51-G01 s6910 Sandford Rd A1 v210818 180405 Stage 4.doc Version 1.20 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!