Inspection on 06/12/05 for St Anthony`s

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 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 23/06/05

St Anthony`s 09/09/04

St Anthony`s 13/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 St Anthony`s St Anthony`s 7a Roseberry Road Langley Vale Epsom Surrey KT18 6AF Lead Inspector Deavanand Ramdas Announced Inspection 6th December 2005 10:00 St Anthony`s DS0000013795.V251247.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 St Anthony`s DS0000013795.V251247.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. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Anthony`s Address 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) St Anthony`s 7a Roseberry Road Langley Vale Epsom Surrey KT18 6AF 01372 278542 Mrs Marie Rajendra Mrs Marie Rajendra Care Home 5 Category(ies) of Learning disability (5) registration, with number of places St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 25-65 YEARS Date of last inspection Brief Description of the Service: St Anthonys is a detached property providing personal care for five service users with a learning disability. The property is in Langley Vale on a residential road backing onto Epsom Downs and the Derby Race Course. The home has five large single bedrooms, a lounge, dining area, conservatory, kitchen, toilets, bathrooms and a laundry. The home has a large garden to the back of the property that is private, secure and easily accessible. Private parking is available to the front of the property. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out by one inspector over a period of six hours. A tour of the premises took place, care records and documents were examined. The inspector noted some service users living at the home had communication difficulties and judgements were made about them based on their mood and behaviour. The inspector would like to thank the manager, staff, service users and visitors for their contributions to the inspection. A CSCI business card was left at the home for information. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure it has a financial and business plan to ensure the home is financially viable and safeguards the welfare of service users. The arrangements for health and safety must be improved and the home must ensure regular monthly health and safety checks are carried out. The home must complete a staff training needs analysis to ensure progress towards national vocational qualification targets are monitored and achieved. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 6 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 Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2. The homes Statement of Purpose and Service User Guide was good providing service users and prospective service users with details of the services the home provides enabling an informed choice to be made about admission to the home. The arrangements for assessment are adequate ensuring service users needs are assessed and identified. EVIDENCE: The home has a statement of purpose that described the services and facilities on offer that was reviewed and updated by the manager on 3/3/05. The service user guide was reviewed and updated in July 2005 that was in widget format. The manager stated the home had a service user that was admitted to the home on 28/10/05. The inspector sampled the care plan and noted a number of professionals were involved in the assessment process including the specialist support and development team, psychologist and parents and guidelines were reviewed and updated on 21/11/05. The inspector noted the manager was allocated to act as key worker and had arranged a care review for the 9/11/05 to review progress. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9&10 The arrangements for risk assessment are adequate ensuring service users are supported to take risks as part of an independent lifestyle. The arrangements for confidentiality are satisfactory ensuring information about service users are handled appropriately. EVIDENCE: The manager stated the home had risk assessments that were in service users files. The inspector sampled risk assessments and noted they were dated and signed by the manager, key worker and service user. One risk assessment date 27/4/05 covered the use of public transport and was reviewed and updated in August 2005. The manager stated the home had environmental risk assessments that were sampled. The inspector noted the assessment was reviewed in July 2005 and covered the areas of lighting, security and bad weather. The manager stated staffs were aware of risk assessments that were reviewed and updated at care plan review meetings. The home had a statement on confidentiality and during a meeting staff stated they respected the confidentiality of service users. One staff remarked “ we discuss things at staff meetings” and the manager commented information about service users is shared on a need to know basis. The inspector noted service users records were up to date and stored in a locked cupboard in the manager’s office. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 10 St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 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 the following standard(s): 11,15&16. The arrangements at the home for personal development is adequate ensuring service users have opportunities for social contact. The arrangements for maintaining family relationships are satisfactory ensuring service users maintain contact with relatives. The arrangements at the home ensure service users’ rights are respected. EVIDENCE: The manager stated service users had planned activity schedules that were sampled. The inspector noted service users participated in a range of community activities that included working at a garden centre, attending college and going to church that provided opportunities for social contact with peers. The manager stated one service user invited his friend from college for an overnight stay and the home provided meals and refreshments. The home supports service users to maintain family relationships and the manager stated a relative who lived in London visited the home and stayed overnight due to difficulties with public transport. During the inspection a neighbour visited the home for coffee and stated “service users were lucky to have a home as good as St.Anthony’s”. The inspector noted the home had a core statement that reflected choice, respect and individuality and the inspector noted service users St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 12 exercised their choice by moving freely around the home and making tea in the kitchen. The manager stated three service users cooked their own breakfast at weekends with support from staff and one service user who did cooking at college had the opportunity to practice his cooking skills at home. During a meeting a service user stated “he liked cooking bacon and eggs”. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The arrangements for managing medications are good and promote the health of service users. EVIDENCE: The home had a policy on resident’s medications dated 9/8/05 that was reviewed and updated by the manager. The manager stated staff had training in the administration of medications and the inspector noted the manager had an intermediate certificate in the safe handling of medications and a support worker had a medication certificate issued by Surrey County Council dated January 2005. The inspector noted medications were stored in a locked metal cabinet secured to the wall in the office and the home had a procedure for receiving and returning medications to the pharmacy that had an entry dated 16/11/05. The inspector checked the drug administration folder and noted medication record sheets were dated and signed by staff and had a recent photograph of service users. The folder also contained information on the side effects of medications and staff specimen signatures. St Anthony`s DS0000013795.V251247.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): 22 The complaint process at the home is satisfactory with complaints information available to staff, relatives and service users. EVIDENCE: The home had a complaints procedure that was in widget format to make the information accessible to service users. The inspector noted complaints information was displayed in the home and also in the service user guide. The manager stated one service user with computer skills participated in developing the complaint procedure. The manager stated the home had received no complaints since the last inspection and during a meeting staff confirmed they were aware of the complaints policy that was kept in a folder in the office. St Anthony`s DS0000013795.V251247.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): 24,26&30 The arrangements for safety are satisfactory ensuring service users live in a comfortable and safe environment. Service users bedrooms are appropriate and promote the independence of service users. The arrangements at the home for hygiene are adequate ensuring the home is clean and hygienic. EVIDENCE: On the day of the inspection the home was clean, well ventilated and free from mal odour. The standard of décor was good throughout the home and the inspector noted the bathroom was decorated and refurbished with a new bath, toilet and sink. The gardens were neat, tidy and easily accessible with a large pond. Bedrooms were well presented and individualised with display cabinets, pictures, paintings and ornaments. One service user who liked football had a rug of Chelsea football club in his bedroom. The manager stated the home had an infection control policy and the inspector noted the home had an industrial washing machine and dryer. Observations confirmed the home had infection control measures and staff washed their hands regularly. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 16 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&32 The management arrangements for staffing are satisfactory ensuring service users welfare are safeguarded and protected. The arrangements for staff training are adequate ensuring service users are supported by appropriately trained staff. EVIDENCE: The manager stated staff had job descriptions and understood their role and responsibilities. The inspector noted one staff had a job description that outlined his main duties, health and safety and confidentiality that was dated and signed September 2004. The inspector noted the staff member was a key worker and as part of his main duties was responsible for planning care and doing risk assessments. The manager stated staff had the skills required to support service users and stated she had arranged training in challenging behaviour and autism to give staff the knowledge and skills to support a service user admitted to the home with a diagnosis of autism. The manager stated staff understood the needs of service users and were able to communicate with them using verbal and physical prompts. The inspector noted the home had a policy on the management of aggressive behaviour that was dated and signed by staff and reflected good practice in managing challenging behaviours. The manager stated staff are enrolled on the NVQ programme at a local college and remarked due to changes and shortages in assessors the college have been unable to support staff to achieve the St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 17 qualification. This was discussed with the manager and action has been required in respect of this matter. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 18 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): 37,39,42&43. The arrangements for managing the home are adequate ensuring service users benefit from a well run home. The arrangements for quality assurance at the home is satisfactory ensuring service users, relatives and professional participate in the review of the home. The systems for health and safety must be improved to ensure the safety and welfare of service users are protected. The overall management of the service is satisfactory however the home must improve its accountability by having a current financial plan. EVIDENCE: The home has an experienced manager who has a professional nursing qualification and an approved management qualification. The manager is aware of her role and responsibilities that is the implementation of policies and procedures and management of the home’s budget. The inspector noted the manager provided clear leadership to the staff team and staff stated the manager was open and approachable. The home had an annual audit for registered care homes that was completed by the manager and dated August 2005. The manager stated the home used questionnaires to obtain feedback about the home and had regular meetings with service users. The inspector St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 19 sampled minutes of the service users meetings and noted the last meeting was held on the 20/10/05 and attended by four service users. The home had met the previous requirements identified in the CSCI inspection report. The manager remarked some service users attended the Surrey advocacy alliance meetings that is held every two weeks that gave service users the opportunity to discuss matters that affected their lives. The home had a health and safety policy that was kept in the policies and procedures file and a health and safety notice was displayed in the manager’s office. The inspector sampled service records and certificates and noted they were up to date. A PAT test was done on 15/4/05 and a gas safety certificate was issued on the 11/1/05. Temperature records for fridge and freezer were sampled and found to be within normal limits however the inspector noted water temperature in the bathrooms were recorded as 45 degrees centigrade on occasions. The manager stated staff reported any health and safety matters as they arise and the home had no formal arrangements for monitoring or auditing health and safety issues that was discussed with the manager and action has been required in respect of this matter. The manager stated the home had employers liability insurance that was checked and dated 2/4/05. The home had a cash flow statement dated 2003 and the manager stated the home did not have a business or financial plan that was discussed with the manager and action has been required in respect of this matter. St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 20 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 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 2 X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Anthony`s Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 2 DS0000013795.V251247.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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 NMS-YA32 Regulation 18(1)(a) Requirement The registered person must complete a staff training needs analysis and submit an action plan to the commission as to how NVQ training targets would be met. The registered person must submit a copy of the business or financial plan to the commission for information. The registered person must ensure monthly health and safety audits are carried out and documented and water temperatures must not exceed 43 degrees centigrade. Timescale for action 01/02/06 2. NMS-YA43 25(30(c) 20/01/06 3. NMS-YA42 12(1)(a) 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Surrey Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI St Anthony`s DS0000013795.V251247.R01.S.doc Version 5.0 Page 23 - 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!