Inspection on 30/04/07 for Walton Road

This inspection was carried out on 30th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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 Walton Road 61 Walton Road Sidcup Kent DA14 4LL Lead Inspector Lorraine Pumford Unannounced Inspection 30th April 2007 14.00p Walton Road DS0000068288.V337181.R02.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 Walton Road DS0000068288.V337181.R02.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. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walton Road Address 61 Walton Road Sidcup Kent DA14 4LL TBC TBC 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) MCCH Society Limited Donna Gail Prescott Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range of service users is 18-65 years of age. Date of last inspection N/A Brief Description of the Service: The home is registered to provide care for three people who have been assessed as having a learning disability, specifically in this instance autism. The home is owned and managed by MCCH Society Ltd. The home is within easy reach of local transport, services and shops. There is off road parking. Accommodation consists of three single bedrooms all on the first floor. There are shared toilet and bathroom facilities. There is a separate lounge, dining room, kitchen and office on the ground floor. The laundry and designated staff sleeping in room are situated on the first floor. There is a garden to the rear of the property and a garage which is currently used as a storage area. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by one inspector who spent approximately six hours in the home. During that time the manager and staff on duty were spoken with, some policies and procedures were examined and parts of the premises inspected. During the course of the inspection one resident was at home and another returned from the day centre he attends and there were opportunities for the inspector to talk with these residents who also agreed to show the inspector their bedrooms. One resident completed a CSCI pictorial survey and information provided has been included in this report, additionally information provided by relatives has also been included. The home was registered in 2006 and this was the first inspection since the home opened. The fees are still under negotiation with the local authority. What the service does well: A comprehensive assessment is completed of residents needs before being offered a place in the home. Residents are supported to make decisions about there day-to-day lives. Staff support residents to access appropriate day centres, education and training opportunities. Residents have varied opportunities to participate in appropriate social and recreational activities. Information regarding meals is provided in a pictorial format and residents benefit from a varied nutritious diet. Residents are supported to attain an individual and personal identity. Staff respect residents privacy and dignity. There is a comprehensive complaints procedure which is also available in a resident friendly format. Residents are provided with a clean comfortable homely environment. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 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 Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment is undertaken by the placing authority prior to residents moving in. Prospective residents are given the opportunity to visit the home before they are offered a place on a trial basis EVIDENCE: Records pertaining to one resident were examined in detail in relation to the homes assessment process for prospective residents. The initial assessments for the residents had been completed by relevant health, social and educational bodies. The assessment was comprehensive and highlighted the residents needs and the action required to address these. The manager stated that prospective residents had been given the opportunity to visit the premises prior to admission; this was confirmed by a resident who completed a CSCI survey. All residents had been admitted on a trial basis to enable residents time to settle in and staff the opportunity to ascertain if it was possible for them to meet residents needs on a long-term basis. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans must be developed to ensure residents receive the care they have been assessed as requiring. These need to include risk assessments to enable residents to take reasonable risks as part of everyday life. EVIDENCE: The manager stated that care plans were still being developed for residents accommodated. This has been a long process as staff had taken time to photograph numerous relevant places such as train stations; shops and restaurants to produce a pictorial care plan for residents. It was evident staff had also collated information from a number of other professionals i.e. speech therapists, social workers and psychologists, who have provided written guidance for staff to follow. This information along with risk assessments also needs to be collated into the care plan. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 10 Discussion took place with the manager in relation to this, as ideally care plans should be in place prior to a resident moving in to a new placement to enable staff to provide the continuity of care for the person concerned. Now relevant information has been collated action is required to address this issue as a priority. There was evidence that residents care had been reviewed since they moved in to the home, these reviews include the resident and their representative as well as a member of staff from the home. There was evidence in records seen that residents are able to choose how they spend their days for example on the day of inspection one resident had declined to attend college and staff had found appropriate activities for him to undertake at home instead. The resident who completed the CSCI survey stated he was able to do what he wanted during the day, evening and at weekends. The manager stated that all residents required some assistance with managing money. At present two residents are assisted by relatives, and the home is setting up a building society account for the resident who requires staff to help with managing money (see standard 41). Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with activities appropriate to their age and supported to access appropriate education and training opportunities. Residents are supported to maintain contact with family and friends. Residents enjoy a varied nutritional diet. EVIDENCE: From records seen, discussion with staff and residents it is apparent that staff support residents to access appropriate day centres, education and training opportunities and residents have varied opportunities to participate in appropriate social and recreational activities. From talking with residents and comments made by relatives in CSCI surveys it is apparent that residents are supported to maintain links with family and friends however the manager stated that this was an area she wished to develop further. The manager stated that she intended to arrange more Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 12 activities such as barbecues and parties at Walton Road to enable residents to invite their family and friends to visit them in their home more often. Staff stated that residents participation in household activities depends on their individual ability. Records seen indicated that one resident had helped staff to change his bed and undertake the laundry. Staff stated another resident helped lay the table for dinner. Good interaction was observed between staff and residents. Menus seen indicate residents are provided with a varied nutritious diet. Menus are in pictorial format and a resident was able to point out to the inspector meals they would be having during the week. Residents can access the kitchen and one resident was seen to help staff preparing and cooking the evening meal. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff enable residents to receive the medical support they require to maintain good health. Staff provide support to residents to enable them to attain an individual and personal identity and respect residents privacy and dignity when required to assist with personal care. EVIDENCE: All residents seen were wearing clean, age appropriate clothing; it was evident that care staff provide support to residents to enable them to attain an individual and personal identity. Staff were seen to respect residents privacy and dignity when required to assist with a residents personal care. The home operates a key worker system and staff were able to clearly demonstrate their role in relation to providing the care and support they have additional responsibility for. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 14 Record seen indicated that all residents are registered with the local GP and receive support from other community health professionals such as speech therapists as and when required. The manager stated that to date residents have maintained good health, however, she intends to liaise with the surgery regarding the possibility of residents attending annual checkups, to help residents maintain good health on a long-term basis. At present none of the residents require medication and the home does not have a medication cabinet. The manager was advised to obtain an appropriate cabinet for the purpose of housing medication in the event that residents may require medication at some point in the future. The manager stated that all staff have received MCCH medication training. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a comprehensive complaints procedure in place which residents understand and can access. Staff training in relation to adult protection helps safeguard residents. EVIDENCE: MCCH has a comprehensive complaints procedure, which is also available in a pictorial format. The CSCI have received no complaints regarding the care or service provided in the home since the last inspection. Relatives who completed CSCI surveys stated they were aware of the organisations complaints procedure. One relative had raised a concern with the manager, information in relation to this had been appropriately recorded, documentation seen indicated the action taken by the manager to address the issue. The manager stated that all staff could access the in-house computer to gain information regarding the organisations adult protection policy and whistleblowing procedure at any time. In addition MCCH have prepared pictorial adult protection information for residents. Staff receive training regarding the organisations adult protection policy at the time of their induction, the manager stated that additionally training updates were provided annually. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a clean comfortable homely environment. EVIDENCE: On the day the inspection all areas of the home were clean. Residents who completed a CSCI survey stated the home is always fresh and clean. The manager stated the home has been decorated and furnished within approximately the last six months prior to the residents moving in. All of the rooms in the house are painted magnolia and discussion took place with the manager regarding involving residents in choosing colours, particularly in their own bedrooms. The manager stated that in this instance relatives had been asked to choose the colour of paint and carpets. Discussion took place with the manager regarding supporting residents to make decisions regarding the future decoration of areas in the home. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 17 There is a good-sized staff sleeping in room and separate office which would benefit from additional shelving and filing cabinets etc. There is a well equipped kitchen and the laundry is domestic in scale which is appropriately equipped for the purpose and accessible to residents. There is a pleasant garden to the rear of the property with a summerhouse there is also a large garage which is currently used for storage purposes only. The manager stated that it is hoped the area will be refurbished and be equipped as a games room which would be of benefit to people living in the home. Each of the residents bedrooms are individually personalised. At the time of the inspection the bedroom ceiling of one bedroom had a large watermark clearly visible. The provider has contacted the CSCI to state the necessary work was completed within the timescale set. . Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The provider needs to ensure that staff are provided with appropriate training to ensure they are competent and able meet the needs of residents accommodated. Evidence was seen that the home has recruitment procedures in place. EVIDENCE: On the day of the inspection the staff rota was inaccurate. One member of staff had arrived three hours early to enable another member of staff to finish work early however the rota did not reflect this, further the rota indicated another member of staff was due to commence work at 2 p.m. however staff stated this member of staff would be working in another home until 3 p.m. Discussion took place with the manager regarding the need for the rota to be an accurate reflection of staff on duty working in the home. At present 90 of the staff working in the home have attained a NVQ 2 or above qualification in care. Staff spoken with stated they felt MCCH provided them with varied training opportunities. However residents living in the home had been diagnosed as having autism and to date staff have received only one Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 19 days training specifically in relation to this issue. All staff stated they felt in need of more training to enable them to understand the condition and meet the specific needs of people with autism and action is required to address this. The manager stated that MCCH maintained a training matrix to enable them to monitor and routinely update statutory staff training in relation to health and safety, food hygiene and manual handling etc. Records were examined in relation to the employment of two members of staff. The Human Resources Department manage the overall recruitment of staff to the organisation and documentation seen confirmed they have undertaken identity, health and CRB checks in relation to staff working in the home. Records seen indicate staff benefit from a comprehensive induction programme and staff receive supervision on a regular basis to discuss practice, training and development. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home benefits from an experienced manager in charge of the home on a day-to-day basis. The provider ensures that regular visits are made to the home to monitor the care and service provided. Regular maintenance and safety checks are undertaken however, action needs to be taken relating to the fact residents are not responding appropriately to the fire alarm. EVIDENCE: The manager has a number of years experience of working with people with learning disabilities and is due to undertake an NVQ4 in Care and Management in the near future. The provider ensures that regular audits are undertaken by them and appropriate specialists to monitor the care and service provided and copies of these reports are forwarded to the CSCI, however these need to be developed Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 21 further to include the views of residents, representatives and other stakeholders. Records were examined for two residents in relation to personal allowance, the amount of money tallied with the records maintained by staff. The inspector discussed one entry with the manager a member of staff had withdrawn money on 14th of December 2006 and recorded small shopping. The manager was advised that staff should record more detailed information in order to protect themselves. Discussion took place with the manager in relation to the fact there are occasions when there is only one member of staff on duty in the house. At present none of the residents accommodated would know the appropriate action to take in the event of the staff member being involved in an accident or incident. A risk assessment should be completed in relation to this and the situation reviewed by the manager and provider to ensure that as far as possible the health and safety of residents and staff is protected at all times. There are weekly checks to the fire alarm system and fire drills have taken place. The manager stated that it is proving difficult to involve residents due to their particular disability. Discussion took place regarding the need to explore the possibility of adapting the system and further liaising with relevant professionals to look for ways of improving residents understanding. Information provided at the time of the inspection indicates that safety and maintenance checks have been undertaken to the fire detection system, gas appliances and electrical wiring. Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 2 X 2 X 2 2 X Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 23 N/A 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 YA7 Regulation 15(1) Requirement Timescale for action 31/07/07 2 YA24 3 YA35 4 YA42 The registered person must after consultation with the resident, or a representative of his, prepare a written care plan. 23(d) The registered person must ensure that all parts of a care home are reasonably decorated in this instance repaint the water damaged bedroom ceiling. 18(1)(c)(1) The responsible individual must ensure that all staff working in the home receive appropriate training relating to understanding and meeting the needs of people with autism. 23(4)(e) The registered person must ensure, by means of fire drills and practices at suitable intervals, that the persons working in the home and, as far as practicable residents are aware of the procedure to be followed in the case of fire. 31/08/07 31/07/07 31/08/07 Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA20 YA39 Good Practice Recommendations It is recommended that the responsible person obtain an appropriate cabinet for the purpose of storing medication for residents when required. It is recommended that the responsible person ascertains the views of residents their advocates and other stakeholders to ascertain ways that the service can improve. Results of surveys should be published and made available to all interested parties. Staff should maintain more detailed records in relation to purchases on behalf of residents in order to protect themselves. Risk assessments should be carried out in respect of staff working alone in the home with residents. 3 4 YA41 YA42 Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Walton Road DS0000068288.V337181.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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