Inspection on 15/08/05 for Shalom Homes

This inspection was carried out on 15th August 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

Shalom Homes 16/08/06

Shalom Homes 08/12/05

Shalom Homes 14/03/05

Shalom Homes 08/09/04

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

CARE HOME ADULTS 18-65 Shalom Homes 110 Griffin Road Plumstead London SE18 7QD Lead Inspector Sue Grindlay Announced 15 August 2005 00:00 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. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Shalom Homes Address 110 Griffin Road Plumstead SE18 7QD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 855 8673 b.fadojutimi@beinternet.com Mr Bode Fadojutimi Cecilia Fadojutimi CRH 3 Category(ies) of MD 3 registration, with number of places Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered as a Care Home with a service category of (PC) care home only Date of last inspection 14/3/05 Brief Description of the Service: Shalom Homes at 110 Griffin Road is a terraced house on two floors in a residential area of Plumstead a short distance from the town centres of Woolwich and Plumstead with their shops and markets. Plumstead train station is at the end of the road, and the 53 bus passes close by. The Home offers care for three adults between the ages of 18 and 65 who have a mental disorder. Service users are supported in their daily living and encouraged to live as independently as possible. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection over six hours. The manager, two staff members and all three residents were seen on the day of the inspection. The Registered Person arrived later in the day. A tour was made of the building, and records were perused. Additional information was gathered from the preinspection questionnaire and from telephone conversations with other professionals. Questionnaires were returned from two service users, two relatives, a Community Psychiatric nurse and the General Practitioner. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 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 Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 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) 1 The Statement of Purpose accurately reflects the aims and objectives of the Home. EVIDENCE: The Home’s Statement of Purpose now includes room sizes and the qualifications of the manager and provider. All three residents have been in the Home since it opened, and the assessment of their needs undertaken at that time is subject to periodic review. Health professionals confirmed that the service user plan was followed within the Home. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 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 and 9 Residents are treated as individuals, and their care plans are drawn up accordingly. Risk assessments should be reviewed regularly according to individual circumstances. EVIDENCE: All the residents’ needs are assessed using the Care Programme Approach. Risk assessments were seen for smoking, and for going out alone. One resident had had several epileptic fits in recent months, but there was no up to date risk assessment for minimising injury in this situation and it is recommended that this be done. Likewise a risk assessment for smoking dealt solely with the fire risk, and the risk to health was not addressed. Risk assessments should be reviewed and revised as necessary. Two of the residents are able to go out unescorted, and have a daily sum of money to spend as they wish. One enjoys going to Greenwich to meet friends, and is able to travel independently. He is discouraged from going out in the evenings, as on occasions he has not come back to the house. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 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, 14, 15, 16 and 17 Appropriate activities and opportunities for socialising have improved since the last inspection, and residents enjoy a comfortable lifestyle. EVIDENCE: Two of the residents have attended a Dating Game course run by the local community resource, and this deals with self-esteem, confidence and, in their words, “making the most of yourself”. One resident was introduced to a gardening group, and went for a few sessions. The employment support worker who introduced him said that staff at the Home had “tried their best” to help him engage with the project. At the last inspection, it was noted that there were few activities provided for the residents, and little incentive for them to pursue any hobbies. This has improved. At a recent staff meeting staff were asked to look out for tickets to events and interesting parks or gardens. Some musical instruments including a xylophone and a flute have been purchased for one resident who likes to play music, and he demonstrated his harmonica on the day of the inspection. He Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 10 also has a supply of drawing materials, which may discourage him from drawing on the walls! Two of the residents went on a group holiday in April to Butlin’s at Minehead with residents from the sister Home in Stratford. One resident, who did not want to go, spent time at the sister Home and went out for visits to places of interest with his key worker. All the residents attended a dance in July at the memorial Hospital Plant Nursery, and they plan to attend a Halloween dance at the end of October. Shopping trips have been arranged to Lakeside, and some residents enjoy a visit to Greenwich Park. Contact with family and friends is promoted. Friends of the residents and a resident’s girlfriend were invited to a barbecue in the garden earlier in the year. Daily reports showed that one of the residents had a visit from his brother and his wife in May. He was also helped to ring his brother whilst the brother was on holiday in Italy. This particular resident is quite sociable and likes to sit at the front door in the nice weather and chat to passers by. Relatives who responded to the questionnaire confirmed that they are able to visit their relative in private and are welcome at the Home at any time. One resident had a recent birthday party, and this was well attended judging by the photographs of the event. This resident was also taken back to his previous Home, to renew former acquaintances. Residents can choose whether to stay in their rooms or sit in the communal areas. Smoking is only permitted in the smoking room on the ground floor. One resident chose to sit in the garden on the day of the inspection, which was warm and sunny, and a member of staff was seen sitting with him and chatting. Another resident was still in bed when the inspection began, but his bedroom door was open, affording him little privacy, and it is recommended that doors be closed when the resident is in bed. The weekly menu included dishes like liver and mash, jollof rice with lamb, or fish stew, and the supper menu was sandwiches, burgers or fish fingers. Lunch on the day of the inspection was roast chicken, pasta and vegetables with a tomato sauce. Residents ate together in the breakfast room and the table (now extended) had a tablecloth and mats. Two residents tucked in, but one resident decided he did not want his meal. It might have prevented the waste by asking him at the outset if he wanted it, and offering an alternative if he said no. This is a recommendation. One resident is on a low-fat diet and one is a vegetarian. A large bowl of fresh fruit was in the kitchen. Meals out are still enjoyed on a Friday with the favourite meal being KFC. It was suggested that this be varied to present new experiences and tastes and to promote healthier eating. In July residents ate at Brothers Buffet restaurant, and a staff member wrote in the log, “the atmosphere was kool and nice”. Residents sometimes help shop for food, and their individual preferences are noted. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 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 standard(s) 18, 19 and 20 Residents are well supported in their health and personal care needs. EVIDENCE: Residents are assisted and supported with their personal care. Two of the residents looked exceptionally well turned out on the day of the inspection, and this is evidence that comments arising from the last inspection have been noted and acted upon. One resident who is quite a large man has a shop catering for his size coincidentally at the bottom of the road. He likes to wear tracksuit bottoms and staff consult him about the colour if he needs a new pair. Health needs are given appropriate attention in the Home. One resident has his blood pressure and weight recorded every two weeks. He recently had a blood test and is waiting for the results of this so that the G.P. can determine whether his medication needs are to be changed. He has also been re-referred to the dietician. Appointments for routine checks with the optician, chiropodist and dentist for all the residents were logged in the diary. Although there is no specialist equipment required, it was noted that the manager has purchased a chair and stool for one resident on the recommendation of the aromatherapist, and this enabled him to sit comfortably in a more supported posture. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 12 No residents are self-medicating. The medication was checked for one resident and was found to be correct. Positive feedback was received from the G.P who confirmed that service users’ medication is appropriately managed, that the Home works in partnership with the G.P. and that he is satisfied with the overall care provided in the Home. It is recommended for good practice that samples of staff signatures are obtained to keep with the medication folder, and when medication is hand-transcribed onto the MAR sheet, the initials of two staff members confirm the accuracy of the recorded information. Although this is a small home, it is good practice to have a photograph of the resident attached to the medical record. These are further recommendations. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Residents appear content and they are given opportunities to express their views. EVIDENCE: No complaints have been recorded since the last inspection, but residents are encouraged to express their views at residents’ meetings or to the manager or responsible person who are frequently present in the Home. The Commission and the G.P have received no complaints. One resident had written on his questionnaire in answer to the question, “Do staff treat you well?” “No”. He was asked about this at the inspection and he said, “They do treat me well. I was just in a mood!” One staff member has attended training on the protection of vulnerable adults since the last inspection. One newer staff member said that their purpose was “to protect them from any abuse, any harm”, but could not say what measures were in place to safeguard clients except “to make sure they don’t hurt themselves”. The Home’s Statement of Purpose talks about “Gentle Teaching”, which is the Home’s philosophy for its work, but this may be insufficiently robust to ensure staff awareness of the complexity of protection issues. The requirement for all staff members to attend training in adult protection is therefore restated. Following the inspection, the manager made contact with Greenwich Social Services and was told that there would be further training early next year, so the timescale for this is matched accordingly. Residents’ money is sent regularly from the Protection and Appointee Team in Greenwich and Care managers audit this on a regular basis. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 14 Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28 and 30 The Home is an ordinary domestic environment. Rooms are of a generous size, and recent improvements to the fabric of the house make it a comfortable place to live. EVIDENCE: The front of the house has undergone a transformation since the last inspection. The house has been painted; there is a newly laid tile path, a gate, and flowers in the flowerbeds, altogether a more welcoming approach to the house, and comparable with its neighbours in the street. A new carpet has been laid in the office, and there is new flooring and a new shower curtain in the bathroom. Toilet seats have been replaced in both toilets, and an outside tap has been installed for watering the garden. Some flowers and shrubs have been purchased for the back garden. The maintenance book lists items raised in a staff meeting in July. All these repairs have now been done. All the residents have good-sized bedrooms, decorated and furnished adequately, and with evidence of personal interests, for example one resident had some storage units for his art materials, and another had a CD player that he was listening to during part of the inspection day. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 16 The shared space includes a breakfast room, furnished with a comfortable settee and chair plus dining table and chairs and a large television, a smoking room and a small patio in the garden. The Home was clean and tidy throughout, and soap and paper towels were available for hand washing in the toilets and the kitchen. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 36 The small staff team is newly constituted, but they are operating effectively to meet residents’ needs. EVIDENCE: This is a small Home and the rota shows that there are generally two staff on during the day and one at night. Relatives who responded to the questionnaire said that there were sufficient staff on duty. One professional respondent indicated that there was not always a senior member of staff available to speak with. One staff member said that her induction had helped her learn how to take care of the residents, and said, “they need our help, that’s why we are here”. Questionnaires from relatives, service users and other professionals reported favourably on the staff members’ understanding of client needs, communication with the professional network and the incorporation of specialist advice into the care plan. One relative wrote, “staff at the Home are always welcoming, kind, understanding and caring of their charges”. Supervision takes place approximately two-monthly and is recorded. The supervisor and the supervisee sign the record. It was a requirement of the last inspection that a staff training programme be devised and a copy sent to the Commission. Although training was not looked at during this inspection, as there are two new staff members, this is a restated requirement, and will be looked at in detail at the next inspection. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 18 Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41 and 42 The Home is now being managed more effectively and systems have been put in place to monitor the way the Home is run. EVIDENCE: The manager of the Home is now back full time having been studying. Subject to funding she plans to begin her Registered manager’s Award in September. The Responsible Person visits the Home on a regular basis and when he arrived on the day of the inspection staff and residents greeted him enthusiastically. Staff meetings are now taking place on a Saturday at approximately monthly intervals and house meetings for the residents likewise. The record of one recent meeting ended with the words, “Finally I promised them that the Home management is committed to excellent service and we will improve on a daily basis to meet the care standards”. There is evidence that managers carry out a monitoring role in ensuring that records are maintained satisfactorily. For example the Home has a self-assessment checklist to gauge how well it is Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 20 meeting the standards. A service user satisfaction survey was carried out in June. A number of new policies have been introduced, including one, as recommended, on continence promotion. Policies are signed on the back by staff members and are reviewed annually. Notifications are sent to the Commission appropriately for events affecting the well being of residents, for example, one resident is subject to epileptic fits and another sometimes fails to come home at night. These show that appropriate action is taken. Evidence from this inspection show that the Home’s manager and responsible person responded to the poor report from the last inspection. At the staff meeting on 14/5/05 a member of staff gave a briefing on the Care Standards, and a topic raised in the meeting for 16/8/05 was ‘pre-inspection clear-up’! Safety issues have also been addressed since the last inspection. One resident who used to paint his light bulb now has a light fitting in his bedroom that is flush with the ceiling. The boiler was serviced on 28/6/05 and portable appliance testing was carried out in on 25/6/05. The Home has a three-zone fire alarm system with smoke detectors in every room including the storage room and utility room. A fire drill took place on 6/6/05 and the record logged the response of all the residents, and action taken in respect of noncompliance, which involved explaining to the resident the purpose of the drill and stating the intention to prepare the resident before the next occasion. A beeping noise identified during the inspection was brought to the manager’s attention, and this proved to be the battery in the alarm system, which is now replaced and the system has passed inspection. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Shalom Homes Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 23 Regulation 13(b) Requirement Staff members should all receive training in Adult Protection. Restated requirement - previous timescale 29/4/05 not met A staff training programme should be devised and a copy sent to the Commission. Restated requirement - previous timescale 29/4/05 not met Timescale for action 27 Jan 2006 28 Oct 2006 2. 35 18c(i) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 6 16 17 20 20 Good Practice Recommendations It is recommended that revised risk assessments are drawn up in respect of smoking, staying out and specifically for the resident with epilepsy. It is recommended that bedroom doors are closed when residents are in bed to maintain privacy. It is recommended that residents are routinely offered an alternative meal if they do not the meal that has been cooked. It is recommended that samples of staff initials and signatures be placed on the medication file. It is recommended that two members of staff initial the MAR charts when medication is transcribed from the G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 23 Shalom Homes 6. 20 prescription to ensure no mistakes are made. It is recommended that a photograph of the resident be placed with their medical details to prevent errors. Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverhouse 1 Maidstone Road Sidcup Kent DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Shalom Homes G51G01s43857ShalomHomesv232979.15.8.2005stage4.doc Version 1.30 Page 25 - 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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