Inspection on 08/04/05 for Templar Street, 16

This inspection was carried out on 8th April 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Templar Street, 16 23/05/07

Templar Street, 16 16/09/05

Templar Street, 16 21/02/05

Templar Street, 16 03/11/04

Templar Street, 16 16/03/04

Templar Street, 16 05/02/04

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Edenvale

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Chatsworth Care - Dawson House

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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 16 Templar Street Camberwell London SE5 9JB Lead Inspector Sonia McKay Unannounced 8 April 2005 08:45 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 16 Templar Street Version 1.10 Page 3 SERVICE INFORMATION Name of service 16 Templar Street Address Camberwell London SE5 9JB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 7274 3687 Royal Mencap Society Mr Patrick Joseph Barry CRH Care Home PC care home only 5 Category(ies) of LD Learning Disability registration, with number of places 16 Templar Street Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 3 November 2004 Brief Description of the Service: 16 Templar Street 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. It is furnished to a good standard. There is a small stable staff team with an experienced manager and deputy who have both been at the home for several years. Mencap provide a broad range of training including a thorough induction. The service users are supported in attending a wide range of educational, social and recreational activities, according to their individual preference and degree of independance. 16 Templar Street Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 7 hours and was completed as one of the two inspections that the CSCI must do each year on all care homes. The home had responded to the requirements and recommendations made in the last inspection report. A full tour of the premises took place and care records were inspected. Both of the staff on duty and all five service users were spoken to. What the service does well: What has improved since the last inspection? What they could do better: Although the statement of purpose and service users guide had been revised, they should be produced in a format more accessible to the residents (i.e. using pictures and symbols). Care planning should be reviewed and should be centred around the needs and wishes of the resident. Plans for health care must be included. The home must also check on all areas of the service that they provide and ask the residents for their views on the home and the service they receive there. 16 Templar Street Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 16 Templar Street Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 16 Templar Street Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 4 Good progress had been made in producing information about the home for prospective service users. Further review is required to ensure that the required information already produced is fully accessible. Staff had good communication skills and tools available. EVIDENCE: The Statement of Purpose and Service Users Guide had been reviewed to include all of the required information about the home since the last inspection visit. The home manager proposed to produce the Service Users Guide 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. The service users had all lived in the home for a number of years. There were no vacant placements. The service users had ongoing input from the local community team for adults with a learning disability, who were able to advise the staff team on behavioural issues and individual risk assessment. Staff were trained in communication and were observed to interact well with the service users. Procedures were in place for the formal referral of prospective service users, assessment of their care needs, introduction to the home, and probationary placement. 16 Templar Street Version 1.10 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9. Staff had provided good support to enable service users to make decisions about their lives with as much independence as possible; mindful of personal safety issues. Person Centred Care Plans must be completed for each existing 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 commented that they each had a keyworker from within the staff team. There were also weekly ‘house’ meetings to enable decisions to be made about the week ahead and also some discussion about how plans for the previous week had gone. Records of these meetings were well maintained and covered a specific and predictable format. Care management reviews had been held recently for all of the service users currently accommodated. Copies of the review meeting assessments and care management care plans were in place for each service user. Internal Person Centred Plans and Health action Plans were yet to be completed. The home manager, house systems and risk assessments aimed to maximise each service users’ independence and choice of activity. Care had been taken to refer ‘capacity to consent’ issues to the appropriate professionals. 16 Templar Street Version 1.10 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17. Service users were supported to enjoy the lifestyle of their choosing and were involved in community life. All were involved in responsibilities around the home and encouraged to take part to the best of their ability. Mealtimes were relaxed and service users were able to choose and prepare meals themselves. Issues of sexual relationships were complex and were being given appropriate professional consideration. EVIDENCE: On the day of the inspection visit three of the service users were attending day centres. Another commented that she was enjoying attending college classes in art and cookery and was looking forward to a family celebration that staff were supporting her to prepare for. The remaining service user was enjoying a lie-in. Two of the service users were able to access the community independently and all of the service users were engaged in a range of community-based leisure 16 Templar Street Version 1.10 Page 11 activities (pub visits, discos, parks, cinema, sports, restaurants and the theatre). Staff were observed to encourage household responsibility for each service user, each service users taking turns to cook the evening meal and complete chores. Records of the meals served and food prepared during the inspection were varied and wholesome. Service users commented that the food “was good”. Considerable assessment was underway around the issue of personal relationships for one service user, with input from social workers and other professionals. The systems in place focused on reducing the risks posed by particular relationships and providing support to obtain the required associated healthcare when required. Issues of ‘capacity to consent’ to sexual activity had been assessed by professionals, with whom the home manager was liasing closely. 16 Templar Street Version 1.10 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, and 21. Service users had received personal support in the way that they preferred and required. Physical and emotional needs had been addressed, but formal health action plans must be devised to ensure that health needs are fully met. 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. Service users commented that getting up and bed times were flexible. Personal care support was minimal in most cases and was carried out by a member of staff of the same sex. Written guidance was available for staff, of 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 had been supported to attend routine GP health checks, specialist services and hospital out-patient appointments. Home visits had been conducted in the privacy of bedrooms. Procedures were in place to address identified health needs, although individual health action plans are required. The home manager was 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. 16 Templar Street Version 1.10 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. Service users views were listened to and acted on. The home manager and staff team had taken steps to ensure that service users were protected from abuse, neglect and self-harm. EVIDENCE: Two of the service users confirmed that they knew how to make a complaint and were clear about who they could complain to. Records of ‘house meetings’ had been kept and indicated that concerns could also be raised in this regular weekly forum. There was evidence that the home had recorded complaints vigilantly. The records kept contained adequate information as to the actions taken and the outcomes and timescales of complaint responses. The complaints procedure had also been produced in a pictorial format and on audio-cassette for greater accessibility for service users with a learning disability. The policies and procedures had been developed for both general use and in response to the individual needs of the service users currently accommodated. This provided a safeguard from physical, financial, psychological and sexual abuse. Recent events for one service user had raised serious adult protection issues. The home managers had taken the necessary action and precautions and were working with the police, social services and community specialists to safeguard the individual. 16 Templar Street Version 1.10 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25 26, 27, 28 and 30. Service users live in a homely, clean, comfortable and safe environment. Bedrooms were personalised and bathrooms were 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 comprised of two lounges, a kitchen and laundry and a small rear garden. Service users agreed for their bedroom to be viewed and were happy with their personal accommodation. The Bedrooms viewed reflected the personal choice and taste of each person accommodated. Bathrooms and toilets were of a sufficient number, with adequate facilities and well maintained. Hot water temperatures were restricted to within safe limits. Records examined indicated that emphasis was placed on environmental checks and safety, although a formal procedure is required to ensure that service users are protected from infection when laundry is carried through the kitchen to the laundry. 16 Templar Street Version 1.10 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 35. Service users benefited from having a staff team with clear roles and responsibilities. Staff were well trained, competent and motivated, although a training plan for the forthcoming year must be devised. Mencap was taking steps to ensure that staffing levels were conducive to meeting the changing needs of the service users. EVIDENCE: The home has a registered manager, a deputy manager and four full time support workers. 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 were understanding of and trained in supporting service user whose behaviour presented 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 was underway although a full training plan for the forthcoming year was not in place. 16 Templar Street Version 1.10 Page 16 Staffing levels were between one and two members of staff on duty during the daytime with one member of staff providing sleepover cover at night. As the needs of the service users had changed, and in some cases increased, Mencap was negotiating with the local authority purchasers with the aim of increasing the staffing levels to ensure that an adequate number of staff were on duty to support service users with supported community access as and when required. 16 Templar Street Version 1.10 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40,41 and 42 The service users benefited from a well run home. Although a service audit that incorporates the views of the service users is overdue for completion. EVIDENCE: The registered manager had been in post for a number of years and is currently undertaking the NVQ 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. Team meetings and service user house meetings had been held regularly and extensive minutes of these meetings were maintained. Discussion with the home manager indicated that an audit of the homes services, required in the previous inspection report, was due to be completed shortly. The homes policies and procedures had been reviewed and were available in the staff office. Records were well maintained and organised and stored securely where necessary (i.e. confidential records). This included records of health and safety monitoring checks and environmental safety certificates. 16 Templar Street Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 Standard No 11 12 13 14 15 16 Templar Street 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 2 x Version 1.10 Page 19 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 3 x 16 Templar Street Version 1.10 Page 20 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 YA1 Regulation 4&5 Requirement The service users guide must be produced in a format that is accessible to service users with a learning disability (i.e. using symbols to support text where necessary). 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 and must be updated to reflect changing needs. A formal procedure must be devised to ensure that laundry is not carried through the kitchen whilst food is being prepared or eaten. The Registered Person must ensure that a quality assurance audit is carried out annually and that the audit incorporates the views of service users. Evidence that action has been taken to meet this previous requirement must be sent to the CSCI Southwark office. A staff training needs assessment must be undertaken and an annual training and development plan formulated. Version 1.10 Timescale for action 30/09/05 2. YA6 YA19 15 26/08/05 3. YA30 13(3) 30/06/05 4. YA39 24 30/09/05 5. YA35 18 29/07/05 16 Templar Street Page 21 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. Refer to Standard Good Practice Recommendations 16 Templar Street Version 1.10 Page 22 Commission for Social Care Inspection 46 Loman Street London 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. 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