Inspection on 16/09/05 for Templar Street, 16

This inspection was carried out on 16th September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Templar Street, 16 23/05/07

Templar Street, 16 08/04/05

Templar Street, 16 21/02/05

Templar Street, 16 03/11/04

Templar Street, 16 16/03/04

Templar Street, 16 05/02/04

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 Templar Street, 16 Camberwell London SE5 9JB Lead Inspector Sonia McKay Unannounced Inspection 16th September 2005 09:00 DS0000022761.V251229.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 DS0000022761.V251229.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. DS0000022761.V251229.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Templar Street, 16 Address Camberwell London SE5 9JB 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) 0207-274-3687 h4056@mencap.org.uk Royal Mencap (Housing & Support Services) Mr Patrick Joseph Barry Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000022761.V251229.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th April 2005 Brief Description of the Service: 16 Templer St is a home for five adults with a learning disability run by the Royal Mencap Society. It is located in a semi-detached property on a residential street with a small front and rear garden. DS0000022761.V251229.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit began at 9 a.m. and was completed in three hours. During the inspection all five of the service users were spoken with as were the two members of staff on duty. Records relating to the care of the service users and the home environment were examined. The inspection also involved a tour of the communal areas of the home and two of the bedrooms. There was also discussion with the registered home manager by telephone. What the service does well: What has improved since the last inspection? What they could do better: Although service users spoken with were confident that their individual life goals were being met, there is a need to review and consolidate all current DS0000022761.V251229.R01.S.doc Version 5.0 Page 6 written information about life and health care planning for each person. 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. DS0000022761.V251229.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 DS0000022761.V251229.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, 3 & 4. Prospective service users have the information they need to make an informed choice about moving into the home. Procedures are in place to ensure that individual aspirations and needs are assessed before placements are offered. This ensures that the home is able to meet these needs and expectations. There is opportunity to visit and to test drive the home before making a decision to stay. EVIDENCE: The statement of purpose and service users’ guide have been reviewed in 2005 to include all of the required information about the home. The service users’ guide has been produced in a format with symbols to make it more accessible to service users with a learning disability. The views of the current service users had been included. This revised guide should be redistributed to the service users accommodated and their of advocates or next of kin. (See recommendation 1). The service users have all lived in the home for a number of years. There are no current vacancies. The service users have ongoing input from the local community team for adults with a learning disability, who are able to advise the staff team on behavioural issues and individual risk assessment. Staff are trained in communication and were observed to interact well with the service users. DS0000022761.V251229.R01.S.doc Version 5.0 Page 9 Procedures are in place for the formal referral of prospective service users, assessment of their care needs, introduction to the home, and probationary placement. DS0000022761.V251229.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10. Staff provide support to enable service users to make decisions about their lives with as much independence as possible. Staff are mindful of personal safety issues. Person Centred Care Plans must be completed for each service user to ensure that their individual needs and life goals are fully documented, supported and implemented by the home staff team. EVIDENCE: The service users spoken with said that they each had a keyworker from within the staff team. This member of staff has special responsibility for meeting with the service user on a regular basis to discuss their individual care and support issues. There are weekly ‘house’ meetings to enable decisions to be made about the week ahead (for example, compiling the cooking rota) and also to provide a forum for discussion about how plans for the previous week had gone. Records of these meetings are well maintained and cover a specific and predictable format. DS0000022761.V251229.R01.S.doc Version 5.0 Page 11 Care management reviews had been held in November 2004 for all the service users currently accommodated. Copies of the review meeting minutes and care management care plans are in place for each service user. Internal Person Centred Plans and Health action Plans are yet to be completed. This had been the subject of a requirement in the April 2005 inspection report that is not met. (See requirement 1). The home manager, house systems and risk assessments aim to maximise each service user’s independence and choice of activity. Care had been taken to refer ‘capacity to consent’ issues to the appropriate professionals. Confidential information is stored securely in a lockable cabinet in the staff office. DS0000022761.V251229.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Service users are supported to enjoy the lifestyle of their choosing and are involved in community life. All are involved in responsibilities around the home and encouraged to take part to the best of their ability. Service users are able to choose and prepare meals themselves. Issues of sexual relationships are complex and are being given appropriate multi- disciplinary professional consideration. EVIDENCE: On the morning of the inspection visit three of the service users were preparing to attend a daycentre. One had already left to attend a vocational class at college and another was preparing for a grocery shopping trip with a member of staff. A service user said I go to the day centre by myself, I am not a child ! All service users have a variety of daytime occupational activities. These activities include a reading club, art class, dance, sports and cookery class. Two of the service users are able to access the community independently (without staff support) and all the service users engage in a range of community-based leisure activities (pub visits, discos, parks, cinema, sports, DS0000022761.V251229.R01.S.doc Version 5.0 Page 13 restaurants and the theatre). There is also a range of leisure activities available in the home (television, music, musical instruments, arts materials, books, games and jigsaws). Service users have holidayed in Lourdes (where they were also able to take part in spiritual activities), Glasgow and at a holiday Park by the sea. A service user said that she had recently enjoyed spending time with her family in Ireland for a special celebration that staff in the home had supported her and assisted her to prepare for the trip. When asked how things were going for her in the home she smiled broadly, gave a thumbs up sign and said Good. Staff were observed to encourage household responsibility for each service user. For example, each service user taking turns to cook the evening meal and complete household chores. Records of the meals served showed that a varied and wholesome range of meals had been available. Food stocks available included fresh fruit and vegetables. Service users said that food was good. Considerable assessment has taken place around the issue of safe personal relationships for one service user, with input from social workers and other professionals. The systems in place focus on reducing the risks posed by particular relationships and providing support to obtain the required associated healthcare and advice when required. Issues of ‘capacity to consent’ to sexual activity have been assessed by professionals, with whom the home manager is liasing closely. DS0000022761.V251229.R01.S.doc Version 5.0 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 the following standard(s): 18, 19, 20 & 21. Service users receive personal support in the way that they prefer and require. Physical and emotional needs are being addressed, although formal health action plans must be devised to ensure that service users benefit from proactive and preventative health care. Medicines are handled safely. EVIDENCE: Each of the service users has a dedicated ‘key worker’ within the team, to assist them with planning, and to provide consistency and continuity of support. Personal care support is minimal in most cases and, if needed, is carried out by a member of staff of the same sex. Written guidance is available for staff about the appropriate level of support to be provided to each individual and their personal preferences. Care records examined and discussion with the home manager provided evidence that service users have been supported to attend routine GP health checks, specialist services (for example, psychiatry, psychology and community nursing) and hospital out-patient appointments as necessary. Home visits are conducted in the privacy of bedrooms. Procedures are in place to address identified health needs, although individual health action plans are required to ensure the proactive health care of each service user. (See requirement 1). DS0000022761.V251229.R01.S.doc Version 5.0 Page 15 The CSCI pharmacist Inspector visited the home in February 2005 to examine in the handling of medicines in the home. There has been good progress in meeting the requirements made as a result of this inspection. Medication administration records, policy and procedure, medication stock handling and staff training are adequate and provide service users with safeguards. The home manager is in the process of discussing the sensitive issues of wishes in the event of serious illness and death with the service users and their families. DS0000022761.V251229.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Service users views are listened to and acted on. The home manager and staff team take steps to ensure that service users are protected from abuse, neglect and self-harm. EVIDENCE: One of the service users confirmed that they knew how to make a complaint and who they could complain to. Records of ‘house meetings’ had been kept and these indicated that concerns could also be raised in this regular weekly forum. There was evidence that complaints were vigilantly recorded. The records kept contained adequate information as to the actions taken and the outcomes and timescales of complaint responses. There had been no complaints made since the last inspection visit. The complaints procedure has also been produced in a pictorial format and on audio-cassette for greater accessibility for service users with a learning disability. The homes policies and procedures had been developed for both general use and in response to the individual needs of the service users currently accommodated. This provides a safeguard from physical, financial, psychological and sexual abuse. The home manager is the state benefits appointee for all of the service users. Detailed financial records are kept for each person, including receipts for all purchase expenditures. A check of these records and bank book and cash balances indicated that staff are vigilant in safeguarding service users from financial abuse. DS0000022761.V251229.R01.S.doc Version 5.0 Page 17 Risk behaviour exhibited by one service user has raised serious adult protection issues. The home manager has taken the necessary action and precautions and is working with the police, social services and community specialists to safeguard the individual. Challenging behaviour exhibited by one service user towards another is being monitored and addressed with input from the local behaviour support specialists and staff vigilance. DS0000022761.V251229.R01.S.doc Version 5.0 Page 18 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, 25, 26, 27, 28, 29 & 30. Service users live in a homely, clean, comfortable and safe environment. Bedrooms are personalised and bathrooms are well appointed. EVIDENCE: The premises are in keeping with the local community. On the day of the inspection the home was bright, cheerful, airy, clean and free from offensive odours. The home offers good access to the local community, local transport and relevant support services. The communal areas of the home include two lounges, a kitchen and laundry and a small rear garden with a patio area and garden furniture. Work is in progress to prepare a new lawn in the back garden. Although the laundry room can only be accessed via the kitchen area, staff are fully aware of the need to remind service users that soiled laundry cannot be carried through the kitchen whilst food is being prepared or eaten. The communal areas are well furnished, homely and comfortable. The home manager confirmed that he has a repairs and renewals programme for ongoing refurbishment in the home. This includes plans to fit each bedroom with a television aerial socket, new laundry room storage cupboards and a new backdoor. DS0000022761.V251229.R01.S.doc Version 5.0 Page 19 Service users said that they were happy with their bedrooms. The bedrooms viewed reflected the personal choice and taste of the occupants. Bathrooms and toilets are of a sufficient number, with adequate facilities and they are well maintained. Hot water temperatures are restricted to within safe limits. Records examined indicated that emphasis is placed on environmental checks and safety. The home manager was pleased to have replaced a faulty thermostatic shower fitting to ensure that service users could not be scalded. During a tour of the communal areas, a garden shed was not locked. It is recommended that the garden shed is locked at all times in the interests of health and safety and home security. (See recommendation 2). DS0000022761.V251229.R01.S.doc Version 5.0 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 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, 33 & 35. Service users benefit from having a staff team with clear roles and responsibilities. Staff are well trained, competent and motivated. Mencap has taken steps to ensure that staffing levels are conducive to meeting the changing needs of the service users. EVIDENCE: The home has a registered manager, five full time support workers and one part-time support worker. Relief cover is provided by a small team of Mencap ‘bank’ staff who are known to the service users, one of whom was on duty on the day of the inspection. Staff were observed to be approachable and accessible to the service users and were knowledgeable of their disabilities, health matters and current social and communication needs. Discussion, observation and training records examined indicated that staff are understanding of and trained in supporting service users whose behaviour presents challenges at times. Staff were also observed to be skilled in the promotion and development of independent daily living skills. Overall, the staff presented themselves as caring, interested, motivated and committed. NVQ training is underway. A full training plan for the forthcoming year is available. Staffing levels have been increased since the last inspection, two members of staff are on duty during the mornings and every weekday evening. DS0000022761.V251229.R01.S.doc Version 5.0 Page 21 One member of staff provides sleepover cover at night. This increase is as a result of negotiation with the placing authority, held as a result of the increasing needs of some of the service users. The staffing increase ensures that there are an adequate number of staff on duty to support service users with community access during the evenings and also increases the capacity of the staff team to monitor and manage any challenging behaviour. The home manager was in the process of recruiting and inducting a new member of staff at the time of this inspection. A member of staff said that she felt well supported in her role by both her colleagues and the registered home manager. DS0000022761.V251229.R01.S.doc Version 5.0 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43. The service users benefit from a well run home. The home manager has a leadership and management approach that service users and staff benefit from. Service users rights and best interests are safeguarded by the home’s record-keeping policies and procedures. Their health, safety and welfare is promoted and protected. EVIDENCE: The registered manager has been in post for a number of years and is currently undertaking the Registered Managers Award, after which he intends to complete the NVQ level 4 in Care. He is experienced and has undertaken other training appropriate to the role. Both service users and staff said that they were able to approach the home manager with problems. Staff said that the home manager is supportive and takes time to listen to their ideas and explain things. Team meetings and service user house meetings have been held regularly and extensive minutes of these meetings are maintained. Discussion with the home manager indicated that an audit of the home’s services, required in the DS0000022761.V251229.R01.S.doc Version 5.0 Page 23 previous inspection report, was due to be completed shortly. Service user satisfaction questionnaires have been completed. The home’s policies and procedures have been reviewed and are available in the staff office. Records are well maintained and organised and stored securely where necessary to maintain confidentiality. Records examined during this inspection provided evidence of:The record of visitors to the home. A record of the dates and times that staff have worked in the home. Regular checks conducted on fire detection and fire fighting equipment. Regular fire evacuation drills. Regular health and safety checks. Safety checks on small electrical appliances and the homes fixed wiring. Safety checks on gas installations. Regular monthly unannounced inspections conducted on behalf of the registered provider, the reports of which have been supplied to the CSCI Southwark office. Employers liability insurance cover. A record of any accident in the home. A record of any complaint or concern about the home. A record of all meals served in the home. A record of medication administered in the home. Financial records held on behalf of service users in the home. Professional inspection of fire safety and food hygiene in the home. Regular temperature testing of the refrigerator and freezers. Regular temperature testing of a hot and cold water supplies. DS0000022761.V251229.R01.S.doc Version 5.0 Page 24 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 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000022761.V251229.R01.S.doc Version 5.0 Page 25 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 6 & 19 Regulation 15 Requirement The registered persons must ensure that Person centred plans, complete with health action plans, must be devised with each service user and reviewed on request of the service user, or at least every six months. They must be updated to reflect changing needs. Previous requirement of 30/08/05 not met. Timescale for action 30/12/05 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 1 24 Good Practice Recommendations The registered persons should redistribute the revised service users’ guide to the home to all current service users and their advocates or next of kin. The registered persons should ensure that the garden shed door is kept locked when not in use. DS0000022761.V251229.R01.S.doc Version 5.0 Page 26 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 DS0000022761.V251229.R01.S.doc Version 5.0 Page 27 - 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!