Inspection on 23/06/05 for St Anthony`s

This inspection was carried out on 23rd June 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Anthony`s 28/03/08

St Anthony`s 03/10/06

St Anthony`s 06/12/05

St Anthony`s 09/09/04

St Anthony`s 13/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 St Anthonys 7a Roseberry Road Langley Vale Epsom Surrey KT18 6AF Lead Inspector Kenneth Dunn Unannounced 23/06/05 10:00 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. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Anthonys Address 7a Roseberry Road Langley Vale Epsom Surrey KT18 6AF 01372 278542 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) Marie Rajendra Marie Rajendra CRH 5 Category(ies) of LD - Learning Disability - 5 registration, with number of places St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The age/ age range of the persons to be accommodated will be: 25-65 years. Date of last inspection 09/09/04 Brief Description of the Service: St Anthonys is a detached dwelling house providing care for up to 5 Service Users in the category for Younger Adults at the time of this inspection only 4 service users were in residence. The service set in Langley Vale on a residential road backing onto Epsom Downs and the Darby Race Course. The home has five large single bedrooms, a lounge/dining room and conservatory. The garden is well maintained with an aviary containing exotic birds in addition there is also a small ornamental fishpond. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours with one inspector. A tour of the premises was undertaken and staff and care records were sampled during the day. Staff were spoken with during the course of their duties and the service users at home during the inspection were also spoken to during the day. What the service does well: What has improved since the last inspection? What they could do better: St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 6 The home must ensure that their policies, procedures, staff recruitment and training practices are followed to ensure that the service users health, safety and welfare are protected at all times. The manager must also ensure that staff supervision is undertaken when scheduled and follows the guidance of the National Minimum Standards. All requirements and recommendations made at this inspection relate to these issues 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. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 Residents have the information they need to make an informed choice about where to live. The home has an appropriate admission procedure in place that includes a needs assessment of an individual and offers the person an opportunity to visit the home on several occasions. Contracts were in place for residents whose files were looked at. EVIDENCE: The statement of purpose was updated last year following a previous inspection of the service by the CSCI. Both the statement of purpose and the residents guide could be made more user friendly for residents in the home and a recommendation from the last report has still to be added to the user guide. The home has not had any new admissions since the last inspection. The admission procedure talks about pre-admission assessments that must be carried out and offers trial visits to the home on numerous occasions. Staff stated that the current group of residents would be actively involved in the process of choosing a new resident. This was not discussed with any of the residents, as we did not wish to cause any confusion or upset. Residents’ files that were looked at contained contracts between the home and the resident and some were signed by the residents, acknowledging their understanding of the agreements. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 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 standard(s) 6, 7, 8 & 10 The systems for service user consultation were good, with a variety of evidence that indicated that residents views are sought in relation to their needs and their lives in the home. There was clear care planning and risk assessing in place these were kept under consistent review EVIDENCE: The staff are in the process of changing over to person centred plans and evidence of the work done was available. This included a great deal of input from the residents who have helped make lists and have given staff their life histories. These plans, are full of information and are very imaginatively designed with the specific service users one plan was styled to look like the Chelsea Football Club badge, a team that the service user is immensely proud to support and relate to. Residents help decide the menus and go with staff to buy the item needed. The written risk assessments are kept under consistent review and the manager is adding to the list of assessments as and when new opportunities are opened. The manger is required to ensure that the service users and or their representatives have the rights to access to information explained and these must be added to the user guide. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 10 St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 17 Links with the local community are very good. The service users are well supported in social and educational aspects of their care. The menus are chosen by the residents with some assistance from staff and offer variety and take into account any individual preferences. EVIDENCE: St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 12 There is an activity programme in place, but this is very flexible and can be altered very quickly. The inspector was informed that the day before the inspection because of the warm evening the events were changed for a barbeque. Residents were encouraged and supported to be as independent as they were able and they all appeared to lead busy and interesting lives, which include attending college, day care, leisure activities, shopping and home time for life skills development. The menu choices involve residents and staff try to encourage residents to join in with the cooking and meal processes by laying the tables, chopping vegetables and stirring the food. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 13 St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 14 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 & 21 The staff have a good understanding of the residents support needs and have good interpersonal relationships with the residents. The health needs were being met with evidence of multi disciplinary working taking place. The manager failed to complete a requirement from the previous inspection report in respect of standard 21 EVIDENCE: All residents are assisted in respect to there personal care needs. The manger stated that this very much varies from resident to resident and this is fully supported in the individual care plans for all the service users. The new work being carried out by the manger and staff towards the completion of Person Centred Plans for all of the service users, will further reinforce the understanding of the service users in meeting the challenges of their daily lives. The manager must ensure that a fully operational policy is introduced covering all aspects of ageing, illness and dying of a resident outlined in standard 21 of the National Minimum Standards for Younger Adults. This is especially the case in light of the age of the resident group, and the health problems that can arise within this age range. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 15 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 Complaints are responded to appropriately and staff are aware of that residents must be protected from abuse, neglect and self-harm. EVIDENCE: The complaint policy was available in written and picture format making it accessible to the residents. Residents were aware that if they are unhappy they could complain to a number of people as shown on the folder given to them. Residents are very vocal and have been told that if they have a problem they can talk to people outside of the home if they want. A resident was heard to be talking to a staff member about an issue they had. The staff member reacted positively and asked appropriate questions to ensure that the resident’s safety was not at risk and there was no chance of an abuse taking place. This was seen as a positive relationship that has been formed between staff and residents. Staff stated that they have received training in the protection of vulnerable adults and try to pass on the information, including the dangers, to the residents to make them more self aware and so they know what to watch out for and what to report to the staff. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 16 St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 17 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, 27 28 & 29 The general standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 18 The fixtures, fittings, furniture and décor are all to a good standard with consideration being given to the client group to be accommodated at the home. On the day of inspection the home was, bright and clean with a homely atmosphere. The service users’ individual rooms have all been highly personalised with the service users’ own belongings and mementos. The provided furniture was seen to be suited to the needs of the service users and to be chosen with care and consideration towards reducing the risk of accidental injury. It was obvious that the service users have a sense of ownership over their home whilst at the same time respecting the other service users’ personal rooms. The rear garden is compact and mostly laid to lawn with an aviary containing exotic birds and a small ornamental fishpond. The rear of the property has a large secure hedge, offering privacy and security. The first floor bathroom was not maintained at as high a standard as the rest of the home and it would benefit from redecoration. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 19 St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 20 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) 33, 34, 35 & 36 All interactions observed between staff and service users evidenced a high degree of respect and skill in working with the individual service users at the home. Staffing is kept under review and provided to meet the needs of the service users at all times. EVIDENCE: The relationship between residents and staff was observed to be relaxed and friendly, creating a warm and homely feel. Residents were encouraged and supported to be as independent as they were able. The staff displayed their skills, knowledge and understanding in all interactions observed. The manger stated that documented, formal supervision for all staff has been scheduled to takes place a minimum of six times a year. However in reviewing supervision files it is apparent that this target is not being met the manager must ensure that staff supervision is given priority. In addition the manager must stop using loose sheets of paper for recording staff supervision. The manager is required to introduce a bound supervision book for each member of staff, these should be signed and dated by the manager and the member of staff. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 21 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, 40 & 41 There is good leadership and consistent direction to staff in this home to ensure that Service Users receive consistent quality care. The manager is fully aware of the needs of the Service Users in the home and as such is able to communicate this to staff through regular staff meetings and individual supervision sessions EVIDENCE: St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 22 The frequency of staff meetings and informal supervision was indicative of an open and supportive atmosphere. Relevant policies and procedures were in place. Systems existed to demonstrate these had been communicated to staff. Also those of relevance to service users had been shared with them. Records examined included; care plans, PCP (Person Centred Plans), medication procedures, staff meeting minutes, risk assessment policies and service user activity programmes. They were seen to be in good order. There were policies and procedures in place for the health, safety and welfare of service users and staff. Detailed policies and procedures were in place in relation to safe working practices. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 23 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 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 3 3 3 x Standard No 11 12 13 14 15 16 17 3 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Anthonys Score 3 3 x 1 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 x x h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 24 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 YA10 Regulation 12(4)(a) Requirement Timescale for action immediate 2. YA21 12(1)(4), 37 Schedules 3.3 (g,k & q) 16(1), 23(1,2) 18(2) 3. 4. YA24 YA36 The manager is required to ensure that the service users and or their representatives have the rights to access to information explained and these must be added to the user guide. The manager must ensure that a immediate fully operational policy is introduced covering all aspects of ageing, illness and dying of a resident outlined in standard 21 of the National Minimum Standards for Younger Adults. The first floor bathroom must be 21/07/05 maintained at a good level of decoration and hygien. The manager must ensrue that Immediate all staff recive supervision and the supervision notes must be kept in a bound individual book. 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. St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 25 Refer to Standard Good Practice Recommendations St Anthonys h09-h58 s13795 St Anthonys v226897 230605 stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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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