Inspection on 27/01/06 for Tooting Bec Gardens, 11

This inspection was carried out on 27th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tooting Bec Gardens, 11 16/03/07

Tooting Bec Gardens, 11 08/08/05

Tooting Bec Gardens, 11 23/02/05

Tooting Bec Gardens, 11 24/09/04

Tooting Bec Gardens, 11 24/03/04

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 Tooting Bec Gardens, 11 Streatham London SW16 1QY Lead Inspector Mary Magee Unannounced Inspection 27th January 2006 14:00 Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 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 Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 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. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tooting Bec Gardens, 11 Address Streatham London SW16 1QY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8769 1235 The Frances Taylor Foundation Mrs Jacqueline Warrick Care Home 8 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include one person over the age of 65 years Date of last inspection 8th August 2005 Brief Description of the Service: 11 Tooting Bec Gardens is one of a number of homes owned and managed by Frances Taylor Foundation a registered charity. The home provides residential care for 8 women with learning difficulties. Accommodation provided comprises of single bedrooms for service users. There is ample well furnished communal space. There is a large garden located at the rear of the property leading into the very pleasant grounds of the residential home/convent next door. It is a large detached house set on a busy route in Streatham but the home is fully double glazed to reduce traffic noise. The home is a minute’s walk from the large shopping centre of Streatham. It is conveniently situated to bus and rail links to Central London and other suburban shopping centres. Tooting Common a large park with a lido and athletics track is within a five minutes walk away. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over an afternoon. The registered manager was present throughout as well as two members of staff. Four service users met with the inspector and shared their views. Two other service users took the inspector for a tour of the premises. The communal areas and two bedrooms were viewed. A selection of personnel records relating to service users and staff members were examined. Currently there is one vacant bedroom. What the service does well: What has improved since the last inspection? The home has developed an effective training and development programme for each staff member staff because of a training needs analysis completed. Staff receive ongoing mandatory training. Continual improvements were seen in the written care plans and the recording of care delivered to service users. Other monitoring charts used to record incidents experienced by service users that include challenging behaviour were found to be useful. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 6 A number of bedrooms have been refurbished. Service users were proud of the improvements made and displayed new personal effects they had purchased to coordinate with the colour schemes they favoured. What they could do better: 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. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 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 Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 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): 2345 Service users enjoy living in a where staff are kind and understand their needs. Service users are fully involved on determining needs assessments and agreeing care plans. EVIDENCE: Individual care plans have been developed and agreed between service users and the home. These are based on care needs assessments undertaken at the home. Initially care management assessments were completed for service users. The majority of service users have lived together for a number of years and have developed good relationships with each other. A caring and sharing ethos is fostered at the home. A former service user returns to visit all her friends at the home regularly. Some restrictions following risk assessments are necessary for service users. Service users are fully involved in risk assessments. Examples of these were seen as agreed by service users and included in care plans. For one service user there are routines in place to ensure that she arrives home safely from her employment. Service users are referred for and receive the services of other professionals in the community. Records show that in the past twelve months service users received the services of the dietician, also psychology and rehabilitation services. Four service users were spoken to. All these conveyed a strong sense of customer satisfaction. They have a strong sense of belonging and shaping the Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 9 service at the home. Service users found that staff are kind and sympathetic and understand their needs. Direct observations made suggested that staff had developed excellent relationships with service users. Despite some changes to the staff team this has not affected the quality or the consistency of the services delivered. Staff receive training and support to enable them deliver the services required. From service user feedback it was evident that the home was successfully meeting their current needs. The home has one vacancy for some time. Current service users are invited to meet prospective service users and assist in decision-making regarding admission procedure. Service users have contracts outlining terms and conditions. More clarity is needed on information regarding holidays. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 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 10 Service users are consulted and participate in many aspects of life at the home. Care and support needs written in care plans accurately reflect what service users need. These as well as risk assessments are kept under review and are regularly updated. EVIDENCE: The care records for three service users were viewed. Service users have care plans developed that reflected their individual goals and support needs. Care plans developed describe restrictions assessed as and where necessary for some individuals. Care plans contain details on managing service users that are prone to episodes of challenging behaviour. Care plans and risk assessments were regularly updated and reflected accurately current needs. Records are also maintained with the continuous use of monitoring charts to identify patterns of behaviour and help to identify triggers. Service users are allocated key workers that they help choose. Recent staff appointments and changes to the staff team have ensured that the staff team reflect the cultural composition of service users. Service users spoke of their involvement in the staff selection process. Minutes were displayed on the notice board of recent service user meetings held recently. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 11 There is a focus on providing a service led service. Service users spoken to felt that they were given plenty of opportunities to fed back their views and affect the way services were planned. One service user spoke of her experiences, she said “the home is run in the interest of all living here”. Service users receive support to make decisions about their lives. Examples were seen of service users managing their own finances with personal accounts held by individuals. While action is taken to minimise risks to service users training is also given to enable them participate in a chosen activity without restricting their preferred choice. Plans were seen of how service users are supported attend places of work part time and how their return home was monitored in an unobtrusive manner. Service user records are held securely and kept up to date. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 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 14 15 16 Service users receive opportunities for their own personal development. Their rights are respected and have responsibilities recognised in their daily lives. EVIDENCE: When the inspector visited the majority of service users were busy out at events in the community. Those requiring the support of staff were escorted on their journey to and from college. Weekly activity plans are in place for all service users Service users have opportunities to develop and learn practical skills. A number attend adult education colleges. One service user has part time employment in the local home for the elderly. All those living at the home take on responsibilities in turn such as shopping at the local supermarket. They are familiar with the local community and attend worship at the local church on Sundays. Service users are supported to cook and prepare meals. Service users have the chance to meet people and make friends. Service users spoke of the friendships that they had formed with colleagues from college. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 13 Service users choose who they see and are encouraged to have visitors to the home. They attend numerous events at the other homes within the foundation and invite others to their home in return. It was observed how much service users enjoy taking responsibility in their daily lives. Service users offered and prepared drinks for visitors to the home including the inspector. Others take responsibility for household chores and were busy preparing the vegetables for the evening meal. Staff are constantly trying to encourage service users to develop further skills particularly culinary skills. Examples of these efforts seen included the use of fresh ingredients rather than the easy option of using prepared food. The majority of service users spoke of their responsibility for looking after their own bedrooms. They like cleaning and dusting their own rooms and not having others do this chore. Two service users showed their bedrooms and the lovely colour schemes that they had chosen in the past six months. A number of personal effects of service users that include photos are displayed in the communal areas. Service users enjoy holidays that they help choose and that are individualised. Two service users went to Lourdes in France last year. She had requested this holiday and was assisted to book it by the manager. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 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 are supported to take control of their lives and facilitated to manage their own healthcare. Service users are protected by the medication procedures for the home. EVIDENCE: Service users are supported with personal support in a way that maximises privacy and dignity. While on a day to basis service users maintain personal hygiene assistance is given with bathing and showering. A local GP practice provides medical advice and support to service users. Health action plans are in place for service users. The health of service users are closely monitored. Appropriate referrals are made to necessary healthcare professionals. Nutritional needs of service users are regularly monitored. One service user has had trouble with keeping her weight within safe limits. Subsequently a referral was made to the dietician. Times for getting up and going to bed are flexible but governed by and in accordance with plans for the day. For those that are attending college or part time employment it is essential that a structure to the day be in place and to enable attendance at appropriate times. None of the current service users are assessed as suitable to self medicate. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 15 Medication procedures were viewed. Medication charts showed no omissions with accurate records kept of medications received and returned from the home. One service user is in the older age group. It is recommended for future planning that development work is undertaken on dealing with ageing service users. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 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 are confident that their views are listened to and acted upon. Staff are trained on safeguarding people from abuse and neglect. EVIDENCE: The home fosters an environment that welcomes service user views. Regular meetings are held for people to express their views and to shape services for the home. The complaints procedure is displayed on the home notice board in the dining room. There are robust procedures in place to safeguard service users from abuse. Recent training on safeguarding people from abuse was delivered to the staff team. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 26 30 Service users live in a home that is comfortable and that meets their needs safely. It is conveniently located for public services and amenities. EVIDENCE: The premises a semi-detached house is comfortable and homely. It is maintained to a high standard. Bedrooms are beautifully presented and are continually refurbished as required. Some bedrooms have been redecorated and had new carpets. All bedrooms are personalised. The standard of hygiene is good. Service users and staff take a keen interest in maintaining the home to this standard. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 34 35 Service users find that appropriately trained staff meets their needs. The organisation must ensure that recruitment procedures meet with current legislation. EVIDENCE: The home has a staff training and development programme for staff. Staff have job descriptions outlining roles and responsibilities. From discussions with two new members of staff it was evident that they understood clearly their roles. There is an effective staff team employed. New members of staff appointed have received an induction-training programme. This is LDAF accredited. Staff have their training needs assessed and identified and from these appropriate training and development programmes are planned to address these needs. The numbers and skills mix of staff are appropriate to ensure that activities can take place with service users. Regular staff meetings are held. Changes to staff team are positive and reflect more appropriately the cultural composition of service users. At the previous inspection it was identified that more robust recruitment procedures are required. It was not possible to confirm that this had been responded to as no new staff have been appointed since then. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 19 The organisation is not fully aware that a POVA check together with a CRB disclosure check is required for all new staff before they commence work. This requirement is restated as there is no evidence to suggest that appropriate documentation is sought before new staff commence work. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 20 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 42 Service users and staff benefit from an environment that is safely maintained and where the health and safety of service users and staff is promoted and maintained. EVIDENCE: Service users and staff find that the manager provides consistency and clear leadership that they value. The registered manager promotes an environment that is open and inclusive. Evidence was given by service users that the manager listens to their views and works hard at making life better for service users. A number of changes she has gradually introduced which has made a more inclusive environment. Service users are fully involved in planning the shopping, choosing holidays and the selection of staff. There is an effective quality assurance system in place. Yearly development plans are in place for service users. Feedback is actively sought from service users about services delivered and the opportunities given for outside involvement. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 21 The premises are well maintained. Regular health and safety audits are conducted of the premises. Areas identified for repair or attention are responded to promptly. A small number of records relating to maintenance were viewed. Evidence was available that regular fire drills are conducted. The servicing records for fire fighting and heating equipment were examined last time and found to be satisfactory. The electrical certificate and records for PAT testing were viewed. Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 22 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 3 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 LIFESTYLES Standard No Score 11 4 12 x 13 x 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 x 3 3 x 3 x Tooting Bec Gardens, 11 DS0000022770.V280672.R01.S.doc Version 5.1 Page 23 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 YA34 Regulation 19 (1) b Requirement The registered person must ensure that full and satisfactory information is available for all newly recruited staff before they commence work.(This to include POVA check and Enhanced Disclosures from CRB.(This is restated as no new staff since last inspection to evidence that this was the practice) Timescale for action 01/04/06 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 YA21 Good Practice Recommendations The registered person should ensure that issues relating to ageing are dealt with and included as part of future planning. 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