Inspection on 08/12/05 for Shalom Homes

This inspection was carried out on 8th December 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Shalom Homes 16/08/06

Shalom Homes 15/08/05

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 Unannounced Inspection 8th December 2005 11.45 Shalom Homes DS0000043857.V259921.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 Shalom Homes DS0000043857.V259921.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. Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Shalom Homes Address 110 Griffin Road Plumstead London SE18 7QD 020 8471 9533 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) Mr Bode Fadojutimi Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered as a Care Home, with a service category of (PC) Care Home Only, with a Service User Category of (MD) Mental Disorder, excluding Learning Disability, 3 of both sexes. 15th August 2005 Date of last inspection 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 DS0000043857.V259921.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection over three hours. The manager, a member of staff and all three service users were seen. A tour was made of the house, and records were scrutinised in respect of residents’ meetings, staff meetings, one service user file and the staff recruitment file for one new member of staff. A community psychiatric nurse responsible for the care of two of the service users was also consulted about his views of the Home. The majority of the key standards were addressed in the previous inspection four months earlier when significant improvements were noted to the operation of the Home. This inspection focussed on following up previous requirements and recommendations, and covering those key standards not already covered in this inspection year. 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 DS0000043857.V259921.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The individual needs and wishes of all the residents were assessed at the outset and are kept under regular review. EVIDENCE: The service user group remains the same. The three men, two of whom are brothers, have lived together for some time, and appear to get on well together. Assessments made at the time of placement are regularly reviewed to ensure that the placement still meets the service users’ needs. The family of one resident has commended staff at the Home for maintaining him so well in the community. Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Service users are treated as individuals, and their needs and wishes are registered accordingly. Risk assessments and behaviour management guidelines would ensure that staff offer a consistent approach to their care. EVIDENCE: It was recommended at the last inspection that separate risk assessments were drawn up for each service user. The case file of one service user showed a Personal risk assessment that failed to specify the risk factor (i.e. epileptic fits) and it is recommended that separate risk assessments are made for each factor, in the case of the residents going out, smoking and falls due to epilepsy (Recommendation 1). One of the residents has shown some aggressive behaviour and a meeting was held with the care manager and community psychiatric nurse to discuss strategies for managing this. These strategies were not put in writing, and it is further recommended that a set of simple behaviour management guidelines be drawn up for this resident to ensure that staff offer a consistent approach to his care (Recommendation 2). Service users are encouraged to make choices about what to eat and what to wear. One service user was sporting a smart new jacket he had chosen Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 9 himself. The same service user had chosen the colour for his bedroom soft furnishings, and a member of staff had helped him to buy suitable items. Residents’ meetings are held regularly, and residents are consulted about all aspects of living in the Home. A bedroom exchange between two residents has proved beneficial to both. One service user is benefiting from being in a ground floor room, and has become more compliant with going to the toilet. Another has to pass the office now when leaving the building, and was clearly aware of the impact of this when he said, “I’ve stopped sneaking out!” The records showed that members of staff have spent time explaining to one resident the need to leave the building when there was a fire drill. The record stated, “More work to be done with [the resident]”. The manager has obtained a useful checklist for staff entitled, ‘The Practical Management of Epileptic seizures’ and this was to be discussed with staff as a means of promoting independence whilst ensuring the safety of the resident concerned. Shalom Homes DS0000043857.V259921.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): 11, 13, 14, 15, 16 and 17 The recruitment of another carer/driver has meant that residents can get out more. Short holidays are becoming a welcome feature of life in the Home. EVIDENCE: Although the Home is not a faith organization, individual staff introduce texts and prayers to meetings, and there is some evidence that service users might be responsive to this approach. However it is recommended that service users be consulted about whether they want this religious input into their meetings, and the manager should ensure that the religious zeal does not take the place of professional and knowledge-based work with clients (Recommendation 3). Service users take advantage of local resources. They shop in Woolwich and attend art therapy at the Ferryview Health centre. The manager said that they had registered with a gym on Plumstead High street, but had so far not attended any sessions. One service user enjoyed visiting a former Home, and all the service users like a trip in the car. The recruitment of a carer/driver has increased the opportunities for trips out. The member of staff on duty on the day of the inspection was a car driver, and she planned to take the service users to Thamesmead for tea after they had been to their class. The manager Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 11 has a copy of the Greenwich Directory of Mental Health Services, that lists all the agencies working in the borough in this client group, and this may open up new possibilities for suitable activities. Activities at the Home are geared to individual interests. One service user likes to play musical instruments, and got out his guitar and harmonica to demonstrate this. Another likes to read newspapers, and the manager brought him back several papers, some from the previous day, including the Times and the Guardian! Regular visitors to the Home include a priest and an aromatherapist. Two of the service users are going to Butlin’s at Bognor Regis in a few days time, and are returning in time for a Christmas Party. Birthdays are celebrated at the Home, and some family members came to a birthday party a little while ago. The photographs taken at the event were in an album kept in the Home. One resident asked whether his girlfriend could visit the Home, and was told that she can visit up until 11.00p.m. One service user now locks his bedroom door, and this affords him some privacy, as his room is adjacent to the smoking room. A small padlock is on the mailbox fixed to the front door, and this is to prevent service users from taking post. In the past some post had gone missing, so this is a necessary safeguard. The manager confirmed that service users open their own mail. Lunch was being prepared at the start of the inspection, and the table was laid with tablecloth and napkins. The care manager said that service users had no complaints about the food. A bowl of apples was available on the table, and there was a range of items in the fridge. The meal for that day was chicken with spaghetti, mashed potato and mixed vegetables. This was an odd combination with two ‘fillers’, and it is recommended that the manager checks planned menus to ensure that they are wholesome and nutritionally balanced (Recommendation 4). Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 12 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): 18, 19 and 20 Service users are helped to stay healthy. EVIDENCE: Service users are supported in their personal care, and it is an advantage that the Home has managed to recruit another male staff member. Two of the service users can bathe unassisted, and one has an ensuite shower. All three service users looked reasonably well turned out on the day of the inspection. One member of staff has taken some responsibility for reminding one resident to use the toilet, and this encouragement has had some positive results. Service users are supported to attend routine health appointments. One service user was reviewed by the G.P. because he had suffered several epileptic fits. In the medication file there is now a list of staff initials and a photograph of each service user is now attached to the relevant MAR chart. These were both recommended in the previous inspection. The medication administration chart for one service user was looked at. It is recommended that where there is space to record allergies, it is written ‘None known’ if that is the case, rather than being left blank (Recommendation 5). It was also recommended at the last inspection that where medication is transcribed onto the MAR charts, two Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 13 members of staff should initial the transcription, and this is a renewed recommendation (Recommendation 6). Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 14 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): 23 Service users are safeguarded from harm at the Home. EVIDENCE: Certificates dated 15/11/05 were seen for five staff members who had completed the Protection of Vulnerable Adults training in house. The training included a Charter of Rights, signs and symptoms of abuse, alerting and whistle blowing. The manager confirmed that the Home has a whistle blowing policy. She said that the course was intensive, and staff had to complete a worksheet afterwards, to confirm their understanding of the issues. There had been some issues of security in the early days of the project with the front door left open. It was noted during the inspection after the service users had left the building, that the front door was found to be wide open. The Visitors’ Book had no entries since September, and staff should be reminded to close the door after leaving the house, and to ensure that all visitors to the Home sign the Visitors’ Book (Recommendation 7). Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 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 the following standard(s): 24 and 26 Service users live in a homely and comfortable environment. EVIDENCE: The Home is furnished and decorated to create a homely environment. Improvements noted on the last inspection have been maintained, and staff have invested time in adding little touches of their own, such as artificial flowers and new curtains to give the house a welcoming feel. A decorated Christmas tree was on the landing at the top of the stairs. The smoking room needs constant vigilance to be kept clean and tidy as one of the service users likes to draw on the walls. Two bedrooms were seen, and both were clean and tidy, with evidence of personal items and equipment such as a television and a sound system. New curtains had been purchased for one service user in a colour that he chose. One service user has a lower bed to help his mobility and prevent harm from falling out of bed. It was noted once again that only one light bulb was working on a fixture containing three bulbs. This has been mentioned in the past, and staff have said that the room is too bright with three bulbs. It is recommended therefore that three bulbs of lesser wattage be used, or the light fitting changed altogether, so that it does not look merely like poor maintenance (Recommendation 8). Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 16 Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34 and 35 More work needs to be done to ensure that staff are working together as a team, and adopting a consistent approach to the residents. EVIDENCE: Some new staff have been recruited in the past few months and some staff have left, and the changes have been unsettling for the residents. Some tensions also have arisen within the staff group when tasks are not completed by the previous shift. The manager is well aware that team building is crucial for the Home to work effectively, and is addressing this through staff meetings in order to reinforce the policies and principles of the Home. The minutes of the meeting on 3/12/05 record, “There has been improvement in all our work and we all seem to have moved on and we have a good grasp”. A text on the wall of the office read, “Whatever you do, do it heartily as unto the Lord”, and the manager said she believed this was directed at the night staff! The language used in the minutes of staff meetings did not seem appropriate for a professional organization. Words like ‘humility’, ‘shamed’ and phrases such as ‘creating an atmosphere of love and joy for one another’, are worthy sentiments, but are out of place in a professional social care setting. A file for a new staff member contained a photograph; evidence of identity and a criminal records bureau check, but this was from a previous employment. It is recommended that the organization obtain new criminal records bureau Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 18 checks in respect of all staff members (Recommendation 9). A health declaration was included in the staff contract. Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 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 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 and 43 The Home is managed effectively. EVIDENCE: The registered manager is keen to promote good practice, and was responsive to the requirements made at the last inspection, supplying information requested in a short timescale. She appears to have a good rapport with the service users, and has used her negotiating skills on more than one occasion to reach a resolution over a contested issue. She has been unable to register for her Registered Manager’s Award this year, and this remains an outstanding matter. In the light of the required timescale this is now a requirement (Requirement 1). The insurance certificate in the hall is due to expire on 15/12/05, and the manager said that the new certificate might be at the other Home in Stratford. A current certificate of insurance must be available for the Home, and a copy of the new certificate should be sent to the Commission when it is obtained (Requirement 2). Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 20 Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 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 X 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X X X X LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X 2 3 X X CONDUCT AND MANAGEMENT OF THE HOME 2 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 X X X X X 2 DS0000043857.V259921.R01.S.doc Version 5.0 Page 22 NO 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 YA37 Regulation 9(2)(b)(i) Requirement The Registered Manager must register for the Registered Managers’ Award as soon as possible. The Registered Person must ensure that a current insurance certificate is available, is displayed within the Home, and a copy sent to the Commission. Timescale for action 20/01/06 2. YA43 25(2)(e) 20/01/06 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. Refer to Standard YA6 YA6 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 a simple set of behaviour management guidelines be drawn up for the service user displaying challenging behaviour, and all staff are required to read and adhere to these. It is recommended that service users are consulted about whether they want to say prayers at their residents’ meetings. DS0000043857.V259921.R01.S.doc Version 5.0 Page 23 3. YA11 Shalom Homes 4. 5. 6. 7. 8. 9. YA17 YA20 YA20 YA23 YA26 YA34 It is recommended that the Registered Manager checks all planned menus to ensure that meals are nutritionally balanced. It is recommended that where the MAR chart records allergies, it should be stated’ None Known’ rather than being left blank. It is recommended that two members of staff initial the MAR charts when medication is transcribed from the prescription to ensure no mistakes are made. It is recommended that staff are reminded to close the front door, and to maintain a record of all visitors to the Home. It is recommended that light bulbs of a lower wattage are replaced in the light fitting with three bulbs, or the fitting changed to a different design. It is recommended that new criminal records bureau checks are made for all newly-recruited staff. Shalom Homes DS0000043857.V259921.R01.S.doc Version 5.0 Page 24 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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