Inspection on 18/05/06 for Swallows, The

This inspection was carried out on 18th May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Swallows, The 11/07/07

Swallows, The 04/10/05

Swallows, The 28/04/05

Swallows, The 02/09/04

Swallows, The 11/05/04

Similar services:

Queen Elizabeth House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Swallows, The 318 Brownhill Road Catford London SE6 1AX Lead Inspector Barbara Ryan Unannounced Inspection 18th May 2006 10:30 X10015.doc Version 1.40 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 DS0000025645.V295197.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 Older People. 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. DS0000025645.V295197.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swallows, The Address 318 Brownhill Road Catford London SE6 1AX 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) 0208 4613391 020 8461 1200 Mr Alan Wilde Mrs Susan Wilde Mrs Susan Wilde Care Home 19 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (19) of places DS0000025645.V295197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 19 elderly persons of whom up to 12 may have dementia 4th October 2005 Date of last inspection Brief Description of the Service: The Swallows is a private care home managed by the same proprietors since opening in 1984. It is a large Victorian house situated between Lee and Catford, within walking distance of shops and public transport. It is registered for older people and people with dementia. The home is no longer registered for those who are physically disabled. The home has 13 single rooms and 3 shared rooms. It is centrally heated and attractively decorated. Washing facilities are available in all bedrooms and there is a 24-hour nurse call system. There are two lounges, dining areas and a conservatory. There is a garden with a patio area for use in good weather. Service users are encouraged to bring in personal items of furniture and mementos to personalise their bedrooms. Bathrooms and toilets have aids and adaptations available. Visitors can be entertained in all of the communal areas and in private bedrooms. The home can provide information about their service through the service users guide and statement of purpose. There is also a folder with responses from a questionnaires completed by various health professional that visit the home. There is information on the notice board that a copy of the last CSCI inspection report is available in the information folder as well as a copy in resident rooms. Fees are from £466 to £475 for week. There are additional charges for toiletries, hairdressing and newspapers. DS0000025645.V295197.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on 19/5/06 between 10.30 and 5.30 pm. The inspection included a tour of the building, discussion with 4 residents the manager, visiting relatives, and two members of staff as well as inspection of four care plans and residents’ files. What the service does well: What has improved since the last inspection? What they could do better: The home need to continue work around drawing up plans for a shower room and reduce to 80 the number of shared room. It is acknowledged that the home needs information from the local authority around what services they will be commissioning from them this year, before they came complete their plans for these two issues. The manager of the home is an experienced and DS0000025645.V295197.R01.S.doc Version 5.2 Page 6 competent manager with a nursing qualification. The home needs to ensure that the manager complete the level NVQ level 4 in management and care or continue to explore other management options. 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. DS0000025645.V295197.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000025645.V295197.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5. Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. Residents have sufficient information to make an informed choice with regard to moving to the home, their needs are fully assessed and contracts of terms and conditions are given to residents. EVIDENCE: The home’s statement of purpose contains full information, and has been updated to include information about staffs NVQ qualifications and about how to contact independent advocates. The home have a policy of assessing all residents prior to admission, they receive a full assessment from the professional team involved with the prospective resident and the home will assess the person themselves. The manager is in the process of revising their own assessment tool to include further sections around behaviour and mental health issues to ensure that all areas of need are fully explored prior to offering a place to the person. The home have a policy of inviting residents to visit the home prior to moving there, and residents spoken to confirmed that this was something that some of DS0000025645.V295197.R01.S.doc Version 5.2 Page 9 them had done. If they are not able to visit, which is an increasing issue for residents that are in hospital, then relatives will visit the home. All the residents files looked at had a contract of terms and conditions present on them. DS0000025645.V295197.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. Residents benefit from comprehensive and up to date care plans, their health needs are meet and they are treated with dignity. Their wishes with regard to arrangements at the end of their life are recorded. EVIDENCE: Four care plans were looked at. The home has a comprehensive and recognised system of care planning. This system has recently included further sections in its format that the home have found helpful in gathering and recording information about residents’ life history, family relationships, circumstances as well and social aims and objectives. There had been a recommendation that the home develop more expansive life histories to use in conjunction with reminiscence work. The manager felt that the new sections in the care plans detailed above have been helpful and the home are using these with regard to developing their life history record for residents. The care plans were up to date and detailed resident’s needs and how they should be met. The care plans contain risk assessments, sections on weight, nutrition and skin care. Residents will have an individual plan for monitoring their weight, either DS0000025645.V295197.R01.S.doc Version 5.2 Page 11 monthly, 3 monthly or yearly as appropriate for their needs. The home have a resident who receives a visit from the GP every two weeks, they will on that visit see other resident if they need to see the doctor. However the home manager said that they would usually make appointment for residents and take them to the GP in the normal way or arrange a home visit. The home liaises with other health professionals such as district nurse, opticians, dentist and so forth. The home is registered to take residents with dementia. Care plans have various sections to complete to ensure that mental health and behavioural issues are identified and actions and objective monitored and recorded. There is a supportive routine within the home that whilst flexible, supports residents that have difficulties with memory and cognition. Care plans are reviewed monthly by the key worker. At times entries were very short and related to more domestic tasks, which whilst very important, did not give a picture of the resident’s well being, changes or general situation over that period. The home should continue to work around these areas and the manager said that she was working to improve this. The home manager has drawn up an information and guidance sheet for night staff around risk assessments, as recommended at the last inspection. A brief inspection of the system for managing medication was undertaken. One resident is managing her own medication. Observations of the interaction between residents and staff indicated that residents are treated with respect and their dignity upheld. The home discusses and records resident’s wishes and details with regard to their death and funeral arrangements on their care plan. DS0000025645.V295197.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14,15. Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. Residents find their lifestyle experience in the home matches their expectation and preferences. They are able to maintain links with family and with the community. They benefit from being able to access a healthy and well balance diet. EVIDENCE: The home has a weekly programme of activities and all care plans looked at had an individual programme of weekly activities on them. These had been worked out between the resident and their key worker. The key worker enters the activities that resident take part in, in the home diary; the home finds this the most effective way of recording activities for individual residents. Residents are able to choose whether to spend time in their rooms or in communal areas and some residents choose to live fairly independent lives and not participate in communal activities other than on special occasions. As well as trips out to the local parks or further a field, which are discussed and agreed at residents meeting, the home will arrange fairly short local trips for residents e.g. short walks in the local area. The home have made links with the Pump House Museum and one of the staff have received training to do reminiscence work with residents. The home has purchased various photos and DS0000025645.V295197.R01.S.doc Version 5.2 Page 13 other equipment to support this work. The home has visiting entertainment on special occasions. They also have regular visits from representatives of different religions, which will depend on the individual needs of the residents; at present these are from the Church of England and the Roman Catholic Churches. In the past the home have had residents following other religions and have arranged visits are appropriate e.g. for the local mosque. The home offers a healthy and balanced diet, with choices offered to residents. Meals are served in pleasant surroundings with attractively set tables. The atmosphere at lunchtime was observed to be very pleasant with residents chatting and enjoying the social occasion. DS0000025645.V295197.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. Residents are protected by the policies around vulnerable adults and there is an appropriate complaints procedure in place. Residents are able to access information about advocacy and legal advice. EVIDENCE: The home have a complaints policy, a copy of which is make available to residents on admission and is also in a file of resident information in the conservatory. The home has investigated one incident since the last inspection and this has been recorded in full detail at the home and the matter dealt with. CSCI was not informed as it was not clear if this was an incident that the home needs to inform CSCI of. The home has an adult protection and whistle blowing policy. The home manager has a training rota and all staff attended training last year; staff are being entered on adult protection training course again this year. The home manager was attending an open day run within the borough the week of the inspection to ensure that she is up to date with any developments in this area. The home has a checklist for staff to support them around monitoring and dealing with this issue. The home has a system for recording which carers supported residents to bed at night and support them with personal care in the morning. They are able to check back to identify which carer provided care and when, that carer will then be responsible for recording any information around bruises or marks and when they were identified. DS0000025645.V295197.R01.S.doc Version 5.2 Page 15 The home has a residents file in the conservatory that has details a number of organisations that would offer support and advocacy to residents and their family if they needed this. There was information about how to obtain legal advice and around appointeeship as well as information for carers. This was left out and available to all residents and visitors. DS0000025645.V295197.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22, 23,24,25,26 Quality in this outcome area is adequate. This judgment is made using available evidence including a visit to the service. The home offers a very pleasant and well-maintained environment, with a choice of communal and dining areas for residents. Resident’s rooms are well furnished and personalised. There is a well-maintained garden that is wheelchair accessible. The home is safe, comfortable, clean and hygienic. The manager is awaiting clarification from the local authority around what will be contracted from them, when they receive this they will then make plans with regard to further work on the building and the use of the three shared rooms. EVIDENCE: The home is situated in a residential street within walking distance of shops and public transport. The home has a large communal sitting room, a second small sitting room and a conservatory leading on to a pleasant and wellmaintained garden. There is ramp access and a paved area for wheelchairs and a grassed area. The home has two dining rooms and can provide a small dining area on the second smaller sitting room as well. Residents are able to smoke in DS0000025645.V295197.R01.S.doc Version 5.2 Page 17 the conservatory. The home is pleasantly decorated and well maintained throughout. There is lift access to the upper floors. There are 3 shared rooms at present. All had appropriate curtaining to ensure residents’ privacy. Residents’ rooms were pleasantly furnished and residents have brought personal belongs as well as items of furniture with them to the home. The home have a CCTV monitor, this is only used to monitor the exits for extra security. The home have had an occupational therapist assessment report that states that there is a need for the home to have additional shower room facilities as at present there are no shower room at the home. The issue regarding the installation of a shower room and the home reaching its target of 80 single rooms are both the subject of, respectively, a requirement and a recommendation. The home is awaiting further clarification from the local authority. The manager hopes that they will have this information very soon and will then be in a clearer position to make plans with regard to the shower room and shared bedrooms. The manager stated that at present residents who wish to shower are able to use a hand held shower in the bath. The home use a pedal bins for the disposable continence waste. DS0000025645.V295197.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. The home is staffed by workers sufficiently experienced and trained to carry out their work and in sufficient number to need resident’s needs. The home has a recruitment policy that protects residents and staff are supported by ongoing training programme. EVIDENCE: The home has sufficient staff on duty to meet the needs of their residents. Staff spoken to as well as resident said that they had time to spend with residents and support them with their care needs without feeling rushed or unable to give the residents the time they need. Over 50 of the care staff have a level 2 NVQ in caring and some staff are exploring to options with regard to future NVQ training. One member of staff had started work at the home since the last inspection and their file was inspected, there was evidence of an appropriate recruitment policy. The home have an induction programme that is comprehensive, a new workbook has been introduced to support the induction programme. The home has a training programme in place and staff confirmed that they are able to access training. DS0000025645.V295197.R01.S.doc Version 5.2 Page 19 Staff were observed to be caring and supportive of residents. Residents and their family described that staff were “marvellous, couldn’t do enough, very patient and kind.” DS0000025645.V295197.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36, 38. Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. The home is being well managed by a manager of good character and experience, however they have as yet not completed the NVQ level 4. Residents’ financial interests are safeguarded. The home does an annual residents and visitor survey and has completed an annul development plan. Staff are supervised but more formal and regular supervision sessions needs to be set up. EVIDENCE: The home is well run and the manager is an experienced and competent person, they have a nursing qualification and many years of experience. At present they have not completed their NVQ level 4 in management and care. The home manager is exploring ways of fulfilling this requirement at present. DS0000025645.V295197.R01.S.doc Version 5.2 Page 21 The home does not act as appointee for any residents. They will hold cash for residents, and will continue to support a small number of residents’ families who have always given them cheques rather than cash to enable residents to access their personal allowance. They have agreed to continue placing this money in the home’s resident account for this small number of residents whose family do not have the facilities to bring cash to the home. The home keeps all residents’ cash in a secure place and all expenditure is recorded and receipts kept. Residents’ financial interests are safeguarded. Residents who are able manage their own finances have a lockable place to keep things. The home completes a residents survey and has also undertaken a relatives and other visitor’s survey. The survey results are available to residents and visitors to look at. The home holds residents meeting and these are seen as a place to pass information to residents as well as hear from them and plan future events. These meetings are minuted. The home does not have to complete Regulation 26 visits as they are owner managers and as such are exempt. The home manager has delegated some supervision of care worker to the two senior care workers. Handovers were described by staff as full and useful. Staff reported that there is ongoing supervision and support around all issues to do with the needs and care of residents. However, there was not sufficient evidence that all staff are receiving formal supervision a minimum of 6 times a years. The home has completed an annual development plan and this has been forwarded to the CSCI. The home carry out fire drills every 3 months, they test fire alarms weekly. Emergency lighting and water temperature is tested by a firm of contactors every 6 months. Records showed that water temperatures were maintained at 43c. DS0000025645.V295197.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X 2 2 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 DS0000025645.V295197.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP22 Regulation 23 (2) j Requirement The registered provider must ensure that a strategy is put in place to action the Occupational Therapist assessment report recommendations regarding the provision of additional shower room facilities. The strategy must detail the work to be done and the timescale for completion. A copy of this plan must be forwarded to the Commission for Social Care inspection. This is a repeat of previous requirement Timescale 31/10/05 now extended. The registered manager must ensure that either she obtains NVQ 4 or alternative options are explored to ensure that whoever manages the home has NVQ at the appropriate level. The registered manager must ensure that all care staff receive formal supervision a minimum of 6 times a year. Timescale for action 01/09/06 2 OP31 9(2) b (i) 01/09/06 3. OP36 18(2) 01/09/06 DS0000025645.V295197.R01.S.doc Version 5.2 Page 24 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 OP7 OP23 Good Practice Recommendations The registered manager should continue the work stated with regard to recording the monthly review of service users’ plans and any action taken. The registered provider should begin now to consider how the home could offer at least 80 of its places in single rooms by April 2007. Details of this financial planning should be included in the business plan for the home. This recommendation is repeated from last inspection. This is a repeat recommendation. DS0000025645.V295197.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 DS0000025645.V295197.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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