Inspection on 05/11/07 for Together Working for Wellbeing (Southbury Road)

This inspection was carried out on 5th November 2007.

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

Other inspections for this house

Together Working for Wellbeing... 31/07/06

Together Working for Wellbeing... 06/02/06

Together Working for Wellbeing... 20/09/05

Together Working for Wellbeing... 10/01/05

Together Working for Wellbeing... 08/06/04

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

CARE HOME ADULTS 18-65 Together Working for Wellbeing (Southbury Road) 87 Southbury Road Enfield Middlesex EN1 1PJ Lead Inspector Brian Bowie Key Unannounced Inspection 5th November 2007 09:00 Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.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 Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.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. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Together Working for Wellbeing (Southbury Road) 87 Southbury Road Enfield Middlesex EN1 1PJ 020 8342 1593 020 8362 9004 Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.together-uk.org Together Working for Wellbeing Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st July 2006 Brief Description of the Service: 87 Southbury Road is managed by Together: Working for Wellbeing (formerly MACA), which provides services throughout the country for people with mental health problems. The home accommodates nine residents. There are three bedrooms on the ground floor and six bedrooms on the first floor. The home is wheelchair accessible. There is an adapted bathroom and toilet on the ground floor. The building has a lounge, dining room and kitchen. There is a separate laundry and a spacious garden to the rear of the building. The home is within walking distance of the local shops. There are good public transport links. The home aims to provide a supportive and rehabilitative environment where residents can improve their skills and confidence and move onto more independent accommodation. Fees at the time of the inspection were £892/week approx. Together makes inspection reports and information detailing the service provided by 87 Southbury Road available to residents and families. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and lasted 9 hours. The manager and deputy assisted with the inspection. We were helped by an Expert by Experience. This is an individual who has had some experience of using mental health services or has a relative who has. The home was looked round and 8 of the 9 people resident in the home at the time of the inspection were spoken to in order to get their views about the home. At the time of the inspection there were no vacancies. Care staff on duty were also interviewed. A variety of records, including care plans, risk assessments and health & safety documents, were looked at. We also looked at the AQAA (Annual Quality Assurance Audit) that the management team at the home had completed and which provided detailed information about the service provided at 87 Southbury Road. ‘The manager & her deputy in particular seemed dedicated to making Southbury Rd a good place to live & I would have every confidence in recommending this home to a member of my OWN family.’ This was the view of the Expert by Experience who spent several hours at the home on the day of the inspection. We would agree with this assessment and our overall impression from the inspection was of a home that had been through a difficult period after the previous manager had moved on and was now operating well once more. However a number of areas need attention to ensure that the home remains at this level. As a result the overall standard of care has increased from adequate to good with the Expert by Experience summarising the home by saying: ‘I would be happy to live here, or a relative of mine. happy and get out.’ The residents seem What the service does well: ‘I feel I have made good progress here at 87 Southbury Rd, Enfield. I feel I am much more confident at saying what I want personally.’ This was the view of one resident and reflected the positive feedback from residents at the home. The home now receives additional support so that it can enable people to gain confidence and skills in order that they are ready to move on to more independent accommodation within 2 years of moving into 87 Southbury Road. As a result residents are benefiting from this exta support, their mental health is improving and they are becoming more independent. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 6 ‘They give good advice. They know what you are capable of. They are very good listeners. They act fairly and accordingly to needs met by myself.’ This was the comment of one resident about staff at the home. 87 Southbury Road has a committed and experienced team of staff. As a result residents benefit from being supported by staff who have got to know them well and who can respond appropriately to their needs and wishes. ‘We can go to the cinema, visit places. I think staff do try to facilitate a wide range of activities. At the end of the day staff do a good turn.’ As a result residents are getting out and about more in their local community and are becoming more confident when out of the home. In this way they are then better prepared for living in a more independent situation. The home supports residents to maintain links with their families and relatives, with residents visiting their families on the day of the inspection. The staff team has built up good links with other mental health professionals so that residents’ difficulties are responded to promptly and effectively. What has improved since the last inspection? What they could do better: 7 areas for improvement are identified at this inspection. In order to ensure the needs of residents are met at all times Together must ensure: Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 7 • • • • • • The hall and office carpet are replaced The upstairs bathrooms have towel rails refitted and are made more attractive The front gate is refitted At all times there is proper and comfortable heating in place in the home All staff have at least 6 supervision meetings each year in order to guide and improve their care practice Together’s procedures for getting written feedback about the care at the home from all key parties, including residents, relatives and professionals are implemented Monthly reports are made by a senior member of Together staff, who is independent of the home, that look critically at the service being provided and ensure necessary improvements are made • 3 recommendations to improve practice further are made: Together should provide a computer for the benefit and education of residents at the home Together should investigate the possibility of providing a quiet room or area at Southbury Road All staff should be trained in person-centred planning to strengthen Together’s efforts to improve how Southbury Road is run The acting manager emphasised that she and her staff team are keen to work closely with CSCI to raise standards further at the home in order to be able to provide the best possible quality of life for residents. 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. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 8 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 Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 9 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): 2 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is good at ensuring people moving into the home have their needs and wishes assessed so that the home can be confident that it can meet these needs and wishes. Southbury Road is good at enabling prospective residents to visit and have trial stays at the home before they decide if they want to move in. EVIDENCE: ‘I had a look round this care home before I moved in.’ This was the comment of one resident and indicates people are able to visit Southbury Road before they move in so that they can make a more informed choice about whether it is the right place for them. 2 residents who had recently moved into the home were spoken to and said they liked living at Southbury Road. The manager confirmed that staff at the home work very closely with the mental health team from Chase Farm hospital. As a result Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 10 Southbury Road has been able to support people with more complex needs, with 5 people placed in the last year and no placement breakdowns. The assessment form used by Southbury Road has a section on religious or cultural practices so that these needs can be identified and responded to. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 11 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): 6,7,9 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit by having care plans that set out clearly and in detail their needs and wishes so that these needs and wishes are met by the home. Residents are enabled by staff to make lots of decisions for themselves so that they become as independent as possible. Residents have the protection of up to date risk assessments to ensure their safety is maintained. EVIDENCE: ‘I feel I have made good progress here at 87 Southbury Rd, Enfield. I feel I am much more confident at saying what I want personally.’ Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 12 Feedback from the residents was positive about the home. Throughout the inspection residents interacted well with staff and were able to make their needs and wishes known. The care plans sampled were detailed and covered the key aspects of the resident’s life, including diversity issues. There was positive written feedback from professionals involved with the home, including social workers and community psychiatric nurses, which indicated residents are progressing at Southbury Road. Staff have 1-to-1 meetings with the residents for whom they are the ‘keyworker’. Notes of these meetings were seen and showed how aims listed in the care plan are being followed through by staff. ‘Residents have a free hand here. They have choice. They’re more confident with staff.’ This was the comment of a member of staff. Throughout the inspection residents chose when they got up, when they had their meals and when they went out. As a result residents have become more confident and more able at make their own decisions about how they lead their life. Residents’ meetings are also held to give opportunities for residents to contribute their ideas and views on how the home is run. The Expert by Experience also noted: ‘Most residents were happy to chat & told me they came & went as they pleased. One resident had been shopping & showed me 2 CDs he had bought. One resident had been to the bank. The proximity of the home to shops & local services was beneficial.’ Care plans contain risk assessments. There is now a more rigorous process in the home to ensure that risk assessments are regularly reviewed and updated. Risks have also been minimised by the increased level of input from the mental health team so that mental health issues can be responded to more quickly and appropriately. This increased support is enabling the home to support residents through difficult periods rather than their having to be readmitted to Chase Farm. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 13 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): 12,13,15,16,17 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is good at enabling residents to get out and about and lead as ordinary a life as possible. Residents are getting a better quality of life because of the good links with the local community and the range of leisure activities available. Residents benefit from the close contact they can have with friends and family if they wish this. Residents benefit by having staff who respect their rights and encourage them to act responsibly. Residents enjoy their meals and benefit from being offered a healthy diet. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 14 EVIDENCE: ‘Two members of staff were playing scrabble with one resident & there was laughter & pleasant interaction between staff & residents. Staff initiated conversations & asked residents how they were, showing genuine concern for their welfare.’ This was the comment of the Expert by Experience. On the day of the inspection the residents were involved in a range of different activities which indicates that residents are developing individualised lifestyles rather than being part of a larger group. For example one resident went to a drop in and saw their GP for a blood test, 2 residents visited their families, 3 went to the cinema with a member of staff, one resident helped with getting the weekly shopping for the home, whilst other residents relaxed at home. As a result residents, with support as needed, can begin to regain some control over their lives and how they spend their time. Resident now go out more than previously since there are more staff to go out with residents. One resident likes to go out to play football or snooker. Residents had also been on trips to garden centres and various places of interest around London. Residents with support had also helped to maintain the garden and improve its appearance. Residents would benefit from the provision of a computer in the home for their shared use so that they could improve their skills in this area. Residents have regular contact with their families if they wish this and in some cases will stay over at their relative’s house. On the day of the inspection a relative called in at the project having earlier spoken to the manager, indicating relatives feel able to visit the home. Residents clearly value these contacts with friends and family and the flexible approach in place so that they can go out and visit people when they want to. Feedback from residents was positive about how staff respect their rights and give them responsibility. One resident has the responsibility of taking prescriptions to the local surgery. Residents also assist with getting the weekly shopping for the home. At the weekend residents help to keep the home clean and tidy. Consequently residents are developing their skills so that they are able to be as independent as possible. Residents are more involved with the running of the home with regular meetings taking place so that people can put forward their suggestions about the running of the home. Where appropriate residents are helped to take as much responsibility as possible in relation to the taking of their medication in order to promote the person’s independence. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 15 Throughout the inspection residents used the kitchen to make themselves drinks or snacks. One of the residents explained that residents plan the menu for each week and choose the meals they wish to eat. The residents, with the assistance of staff if required, prepare the meals. If a resident does not like a particular meal an alternative is offered. Mealtimes are relaxed and flexible to suit the needs of residents. Residents said that they liked being able to choose when and where to eat their meals. Staff encourage residents to eat healthily. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 16 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): 18,19,20 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff are good at supporting the residents so that residents feel happier at the home. Staff are skilled in healthcare so that the physical and health needs of residents are met. Residents are protected by the thorough procedures in place in the home in relation to medication. EVIDENCE: ‘This resident is settling well at Southbury Road. They say they feel well in themselves and sounded happy with their placement at Southbury Road.’ Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 17 This was the comment of a member of the mental health team at a meeting to review the resident’s progress at Southbury Road. Each resident has a member of staff who has a special responsibility to meet regularly with the resident on a one-to-one basis in order to respond to and meet their individual needs. Staff interviews indicated that staff had a good understanding of each resident’s needs and were working hard to meet these needs and wishes. ‘The service provides help and support to people discharged from hospital enabling them to regain lost skills and confidence to move on. Friendly, helpful staff.’ This was the comment of a member of the multi-disciplinary team about 87 Southbury Road. Feedback was positive from residents and staff about the home’s ability to support people with significant mental health needs and to enable them to progress. The manager said: ‘We have excellent input from the mental health team.’ This input is enabling people to develop the confidence and skills they need to move on to more independent placements. Medication records were accurate and up to date. Thorough procedures are in place to ensure that residents have their medication reliably as prescribed. All staff have had training in how to administer medication safely. The home now uses the monitored dosage system. As a result there are now safer arrangements in relation to medication in the home. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 18 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): 22,23 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a good complaints procedure so that residents and relatives feel confident complaints and concerns will be listened to and acted on. The home has a good safeguarding adults procedure so that residents and relatives feel confident allegations and incidents of abuse will be responded to and followed up. EVIDENCE: ‘I will speak to Mary the manager if I am not happy with anything. I will write in the comments book regarding any issues concerning others.’ This was the comment of one of the residents. If residents have concerns or complaints these are recorded and action taken by staff to try and resolve the issue. Recent concerns had been followed up by staff and resolved. As a result residents feel more confident their concerns are being taken seriously. New residents are told about the home’s complaint procedures when they move in, as well as being given written information about how to make a complaint. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 19 ‘We’re here to protect people.’ This was the view of one member of staff interviewed. All staff had attended, or were scheduled to attend, Safeguarding Adults training so that they know what to do if any incident of abuse, or allegation, is made. As a result residents are better protected and can be more confident incidents will be properly followed up. There had been no recorded incidents of abuse in the last year. Staff are planning to offer further information and guidance to residents in this area so that residents are as fully protected as possible. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 20 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): 24,30 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents at Southbury Road enjoy a homely and comfortable living environment that adds to their quality of life. However some areas of the home need refurbishment so that residents enjoy an attractive and well maintained home. Residents benefit from a home that is kept clean and hygienic. EVIDENCE: ‘It’s your home- it’s ok to do what you want.’ Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 21 This was the comment of one member of staff to a resident and showed that there is a commitment in the staff team to helping residents feel as much as home as possible. Throughout the inspection residents were very comfortable and relaxed in the home. An extension to the downstairs area means that residents with mobility difficulties can be accommodated on the ground floor. The hall and office carpet are worn and need replacing. The upstairs bathrooms need towel rails refitted and need to be made more attractive. The front gate needs refitting. All areas of the home must be properly maintained so that residents at all times benefit from an attractive and well maintained living environment. Heating throughout the home was inconsistent with some cold areas. The manager must review existing arrangements to ensure that at all times there is proper and comfortable heating in place in the home. The home has a communal lounge and dining area, but not another room that can be used by residents to meet in private with friends of family, as a quiet area, or for other private meetings. It is recommended that Together investigates the possibility of providing such a room or area at Southbury Road. The cleaner comes in Monday to Friday mornings. On the day of the inspection the home was being cleaned to a good standard. Feedback from residents was positive about the cleanliness of the home. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 22 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): 32,34,35,36 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have enough competent and experienced staff to support them. Residents are protected by the sound policies and procedures in place in relation to the recruitment of new staff. Residents have the benefit of staff that are well trained, however staff do not have enough supervision meetings. EVIDENCE: ‘They give good advice. They know what you are capable of. They are very good listeners. They act fairly and accordingly to needs met by myself.’ This was the comment of one resident and reflects the positive feedback from residents about the staff. Staff on duty throughout the inspection supported Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 23 residents appropriately. The handover session between staff on the morning and afternoon shifts was observed and showed that staff pay close attention to responding to the needs of residents. Residents get support from staff outside of Together, as well as from staff at Southbury Road. As a result residents get an appropriate level of support. ‘Staff initiated conversations & asked residents how they were, showing genuine concern for their welfare.’ This was the view of the Expert by Experience who observed and spoke with several staff. Staff at the home undertake relevant training courses, such as the NVQ Level 2 & 3 in caring for people so that they are able to support residents more effectively. As a result residents benefit from the support of an experienced and skilled staff team. Files for staff were looked at and contained the information needed to make sure that staff in the home have the appropriate checks made. These checks include obtaining written references and a satisfactory CRB disclosure. These procedures help to ensure that residents are protected from having unsuitable staff working in the home. Staff attend a range of relevant training courses, including medication, health & fire safety, mental health awareness, safeguarding adults. Staff interviews indicated staff are using what they have learnt from training courses to improve their practice. It is recommended that all staff are trained in personcentred planning to ensure that the home is run in a way that takes full account of the individual needs and wishes of the residents. Staff interviews and discussion with the manager indicated that staff are now being more regularly supervised than previously. However the system for supervising all staff at least 6 times annually is not yet fully in place. The manager must ensure all staff have at least 6 supervision meetings each year in order to guide and improve their care practice. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 24 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): 37,39,42 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well run home. Members of staff respond to and act on comments and suggestions from residents about how the home is run. However residents and other key parties do not have the benefit of fully implemented systems in the home for getting feedback about the quality of the service. Residents do not have the protection of regular and critical internal reports by Together about how to improve the service. The home has good procedures in place in relation to health and safety that help to ensure residents are protected at all times. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 25 EVIDENCE: ‘She’s very supportive.’ This was the comment of one member of staff about the new manager, Mary Brennan. Mary Brennan has considerable experience in the mental health area, including running care homes for people with mental health problems. She is being put forward by Together for registration by CSCI as the manager of 87 Southbury Road. ‘There are 8 permanent staff & 4 part time/relief staff & 9 residents & this ratio seems to be having a beneficial effect on residents lives.’ This was the view of the Expert by Experience who spent several hours at the home on the day of the inspection. At the start of each day a list is drawn up of tasks to be done that is then worked through by the staff team. In this way a resident gets support if needed with personal hygiene or with getting to their GP for a blood test. As a result residents have the benefit of living in a well organised home that meets their needs. Records are kept of residents’ monies that were accurate and checked by 2 members of staff to ensure there are fewer errors made. Residents, individually and as a group, put forward their ideas and suggestions on how the home is run. Interviews with staff confirmed this feedback is then followed up by staff, such as organising an outing, the menu for the following week, which days people do their washing and cooking the evening meal. However the manager must implement Together’s procedures for getting written feedback about the care at the home from all key parties, including residents, relatives and professionals. The area manager for Together had in the past visited the home regularly to check how it is doing and identify areas for improvement. However these monthly reports that have to be made by Together about the quality of the service had not been sufficiently rigorous or independent of the service. Together must ensure that the monthly reports are made regularly by a senior member of Together staff, who is independent of the home, and that the reports look critically at the service being provided and ensure necessary improvements are made. Health and safety records were looked at and were satisfactory. Fire safety records were up-to-date and accurate and confirmed that the home is being run responsibly with statutory checks being made and acted on. Procedures had been improved with a thorough health & safety audit of the premises made in October 2007. Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 26 Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 27 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 x 2 3 3 X 4 X 5 x 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000010664.V341926.R01.S.doc 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 x Version 5.2 Page 28 Together Working for Wellbeing (Southbury Road) 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 YA24 Regulation 23 (2) (d) Timescale for action The hall and office carpet are 31/12/07 worn and must be replaced so that residents at all times benefit from an attractive and well maintained living environment. The upstairs bathrooms need 31/12/07 towel rails refitted and need to be made more attractive so that residents at all times benefit from a well maintained living environment.. The front gate must be refitted 31/12/07 so that the home has an attractive and well maintained appearance. Existing heating arrangements in 31/12/07 the home must be reviewed and action taken to ensure that at all times there is proper and comfortable heating in place in the home. All staff must have at least 6 31/01/08 supervision meetings each year in order to guide and improve their care practice. The manager must implement 31/12/07 Together’s procedures for getting DS0000010664.V341926.R01.S.doc Version 5.2 Page 29 Requirement 2. YA24 23 (2) (b) 3. YA24 23 (2) (b) 4. YA24 23 (2) (p) 5. YA36 18 (2) 6. YA39 24 (1) (a) & (b) Together Working for Wellbeing (Southbury Road) written feedback about the care at the home from all key parties, including residents, relatives and professionals, so that the running of the home can take account of these views and wishes. 7. YA39 26 (4) (c ) Together must ensure that 31/12/07 monthly reports on the quality of service provided are made regularly by a senior member of Together staff, who is independent of the home, and that these reports look critically at the service provided and ensure necessary improvements are made. 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 YA14 YA24 Good Practice Recommendations A computer should be provided for the benefit and education of residents at the home. Together should investigate the possibility of providing a quiet room or area at Southbury Road so that residents benefit from more choice about where they meet people at the home and where in the home they spend their time. All staff should be trained in person-centred planning. 3. YA35 Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Harrow Area Office 4th Floor, Aspect Gate 166 College Road Harrow London HA1 1BH 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 Together Working for Wellbeing (Southbury Road) DS0000010664.V341926.R01.S.doc Version 5.2 Page 31 - 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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