Inspection on 10/11/06 for St James` Care Home (21)

This inspection was carried out on 10th November 2006.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St James` Care Home (21) 28/09/05

St James` Care Home (21) 17/04/05

St James` Care Home (21) 20/09/04

St James` Care Home (21) 03/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 St James` Care Home (21) 21 Old Hospital Close, St James`s Drive London SW12 8SS Lead Inspector Jon Fry Unannounced Inspection 10th November 2006 11:15 St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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 James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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 James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St James` Care Home (21) Address 21 Old Hospital Close, St James`s Drive London SW12 8SS 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) 020 8672 7149 0000 www.thresholdsupport.org.uk Threshold Housing & Support Phillip Burden Care Home 5 Category(ies) of Learning disability (5), Physical disability (1) registration, with number of places St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2005 Brief Description of the Service: St James (21) is a care home for five adults with a learning disability. The home is located in a residential road in Balham close to local shops and transport links. The home is run by Threshold Housing and Support. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector on the 10th November 2006 over five hours. The inspector talked individually with two people who live at the home. A number of records were examined and discussions took place with the manager and two staff members. Completed surveys were received from two staff members. What the service does well: What has improved since the last inspection? What they could do better: All staff must have training around working with challenging behaviour. The managers need to keep reviewing any incidents of aggression and how these affect the other people living at the home. The staff team should continue to look at how it can involve the people living there in the daily life of the home. Records kept of consultation with individuals could also be improved to show this involvement. Security measures in place for the building must be reviewed. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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 James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information provided to people living at the home, and to possible new residents, could be improved. Residents are assessed and care plans put in place to address identified needs. EVIDENCE: The home had one vacancy at the time of this inspection and the manager said that there was one person who may come to live there. This individual had not yet visited but their family had come to have a look round the home. A Statement of Purpose and a Residents Guide are in place. We saw that these documents need updating and the manager said that she was doing this. Each document should be presented in ways that possible new residents and their family or friends can easily use to get the information they need. Residents already living at the home may wish to be involved in updating or presenting this information. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 9 Individuals are assessed before they come to live at the home. We saw that these assessments had been completed and kept up to date for people now living there. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good support plans are in place and these address the identified needs of individuals. Individual support is provided to residents to make choices in their everyday lives. Their rights and responsibilities are recognised by the service. The home could look at even more ways of involving the residents and getting them to have more ‘ownership’ of the home. EVIDENCE: The support plans we saw were good. They looked at the person’s strengths and needs and gave clear guidelines for staff around the support required. For example, one person’s plan included information for staff on how to deal with their behaviour so that all staff would work with this person in the same way. We saw that the care plans are reviewed regularly and updated as needed. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 11 Residents are supported, with help from staff as needed, to make decisions about many aspects of their lives. The manager spoke about trying to involve residents even more in the life of the home. One person has now got a communication passport that helps them make their wishes known to others. Staff spoken to said residents are involved in planning menus and choosing places to go for trips. A book is kept to record individual discussions and decisions. We think that this could be improved by using a large diary to record these as this may help to show that residents are consulted regularly about things like menus and activities. The book in use did not show this consistently. It is recommended that the staff team continue to look at how residents could be encouraged to take more ‘ownership’ of the service. Assessments are completed for each resident to look at areas of risk such as their mobility and if they can use local transport by themselves. These show that residents are supported to take risks in order to try to live their lives as independently as possible. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals receive good support to lead meaningful lives and to be as independent as possible. Support is provided to use community facilities but there are ongoing issues with anti-social behaviour in the immediate neighbourhood. EVIDENCE: Residents are able to take part in activities of their choosing. Weekly activities for individuals include attending day centres, local community facilities and inhouse activity sessions One resident said they could go out by themselves or with staff. Another resident was being supported to go out with a 1-1 member of staff on the day St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 13 of inspection. Daily notes for one resident recorded trips to the gym, cinema and day centre. There have been incidents in the immediate neighbourhood involving nuisance or anti-social behaviour. Residents and staff are trying to address these issues and are in contact with the local Police. A Requirement has been made for the home to look at its security in order to make sure residents and staff are safe. One resident said they “liked the food” and could choose what they liked. We saw another resident being supported in making a sandwich for themselves. Staff said that residents are involved in planning the menu for each week but the records kept did not show this. It is recommended that each menu clearly says which people were involved in planning it. Families and friends are welcome at the home whenever residents want to see them. Staff support individuals to keep in touch with their friends and families. As stated previously, it is recommended that the staff team continue to look at how residents could be encouraged to take more ‘ownership’ of the service. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive support to keep healthy through access to a GP and other healthcare professionals when needed. Good support is provided for people to take their medication correctly. Residents are treated as individuals and with respect. EVIDENCE: Care plans showed that healthcare needs are addressed. Residents are supported to visit the doctor’s surgery and other healthcare professionals as needed. Specialist services for people with learning disabilities are also accessed locally by the home. We saw that a referral had been made for one person with challenging behaviour to look at how staff can support them more effectively. We saw that care plans also contained good information about any personal support provided to residents. These gave clear guidance about the best way for care staff to do this. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 15 Administration records for medicines are kept well by care staff. This shows that residents are supported to take their medications as prescribed. We did see one instance where eye drops were not being kept correctly and did not have an opening date recorded. This was discussed with the manager at the time of inspection. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse through the organisations procedures and training. Support is given as necessary to voice any concerns or complaints. EVIDENCE: The home has a complaints procedure on display and a record of all complaints is kept in the office. The CSCI received a number of concerns directly that were passed to the organisation to look into. This investigation was ongoing at the time of this inspection and was being dealt with properly to make sure that the people living at the home are protected. One resident spoken with said they would speak to the manager if something was not right. Another resident said they were “alright”. Staff receive training in Safeguarding Adults (Protection of Vulnerable Adults) and there are policies and procedures in place regarding abuse awareness and what to do in the event of this. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with safe and comfortable accommodation that is generally kept to a good standard. EVIDENCE: We saw that the home is comfortable and is generally well maintained and decorated. Arrangements for staff have improved and there are now suitable sleep in facilities provided. Requirements have been made to make sure that a few minor maintenance issues are addressed by the home. All areas of the property were clean and hygienic at the time of this visit. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are adequate numbers of staff who are generally well trained and competent to meet the needs of residents. Recruitment practices protect the welfare of residents. EVIDENCE: We saw that care staff have access to training and receive regular 1-1 supervision. An organisational training programme is available and courses attended by staff include manual handling, First Aid and Person Centred Planning (PCP). Staff need more training in working with behaviour that challenges the service. The manager said that this was being arranged for care staff. We looked at the personnel records for two members of staff. These were well organised and contained the information required by law. The home makes sure that all care staff have Criminal Record Bureau (CRB) checks. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home. Health and Safety checks carried out protect the welfare of residents. EVIDENCE: The manager has worked at the home for a number of years and is responsible for managing this home and another service across the road. Comments from staff about the home included “a good staff team”, “the service is very good” and “a good manager”. One member of staff felt that there was scope for the management and staff to be more effective in what they do. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 20 The organisation operates a ‘quality toolkit’ system for its homes. This helps to make sure that residents are receiving a good service. Health and Safety checks take place and are generally well recorded. One issue was highlighted where fridge temperatures were too high on a number of days according to the records kept. Staff had not written what actions they had taken to correct this. St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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 Standard No Score 1 2 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X X 3 X St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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 YA1 Regulation 4 (1) 5 (1) 2. YA42 13 (4) Requirement Timescale for action 01/02/07 3. 4. YA20 YA24 13 (2) 23 (2) (b) The Registered Persons must ensure that the Statement of Purpose and Service Users Guide are updated. The Registered Persons must 01/01/07 ensure that action is taken and recorded when refrigerator temperatures are found to be too high. The Registered Persons must 01/01/07 ensure that all items of medication are stored correctly. 01/03/07 The Registered Persons must ensure that: The kitchen floor is repaired or replaced, The 1st floor bathroom floor is repaired or replaced and minor re-decoration is completed by the bath as required. The Registered Persons must 01/01/07 ensure that appropriate security measures are put in place for the protection of residents and staff. The Registered Persons must 01/04/07 ensure that all care staff receive training around working with challenging behaviour. DS0000010229.V317869.R01.S.doc Version 5.2 5. YA13 23 (2) (0) 13 (4) 18 (1) (c) 6. YA35 St James` Care Home (21) Page 23 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 YA1 YA7 Good Practice Recommendations The home should look at alternative user friendly formats for the statement of purpose and residents guide. It is recommended that an alternative format such as a diary be used to record consultation with residents. Staff should continue to look at ways for residents to take more ownership of the home. It is recommended that the menu’s used record who was involved in choosing the meals. 3. YA17 St James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 James` Care Home (21) DS0000010229.V317869.R01.S.doc Version 5.2 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. 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