Inspection on 16/02/06 for Webb Road (1a)

This inspection was carried out on 16th February 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Webb Road (1a) 08/12/08

Webb Road (1a) 23/08/07

Webb Road (1a) 02/08/06

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 Webb Road (1a) 1a Webb Road Blackheath London SE3 7PL Lead Inspector Ms Pauline Lambe Unannounced Inspection 16th February 2006 10:15 Webb Road (1a) DS0000066976.V284427.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 Webb Road (1a) DS0000066976.V284427.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. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Webb Road (1a) Address 1a Webb Road Blackheath London SE3 7PL 020 8858 8918 020 858 8918 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) The Avenues Trust Limited Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7th September 2005. Brief Description of the Service: 1a Webb Road is a residential care home for six younger adults with both physical and learning disabilities. It is a modern chalet style detached building near to Greenwich Park and Blackheath Village. Since the last inspection the registered provider has changed and the new care provider is Avenues Trust Limited. The home currently provides care and accommodation for three female and two male residents. Accommodation is provided on two floors. Bedrooms are on the first floor and communal areas on the ground floor. A passenger lift enables residents to access all areas of the home. To the rear of the property there is a raised garden. This has steps with support rails leading to a gazebo. French windows open from the lounge onto the rear garden. Parking space is provided to the front of the property. Residents are supported to attend day centres, to access local leisure facilities and maintain family contact. A mini bus is provided to enable residents to access external services and activities. Staff have established links with the local Community Learning Disability Team, the local Speech and Language Therapists and Occupational Therapists who support them to meet the needs of the residents. Webb Road (1a) DS0000066976.V284427.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 completed over 5 hours. The service was last inspected on 7th September 2005. At the time of this inspection two residents were in the home and the recently promoted deputy manager was in charge of the home. The inspection included a tour of the premises, inspection of records, care plans and safety systems. Time was taken to talk to staff and management. Residents in the home were unable to voice their views of the service but time was taken to observe the positive staff interaction with the residents who were in the home. What the service does well: What has improved since the last inspection? What they could do better: Staff must sign, date, include review dates and provide evidence of relative involvement when preparing care plans. The oven and extractor fan in the kitchen must be kept clean at all times. The medicine policies & procedures must be reviewed and include the procedures to manage leave medicines, disposal of medicines and medicine errors. The temperature of the medicine storage area must be monitored and the medicine storage cupboards must be kept clean and hygienic. Internal and external medicines must be stored separately. The leak from the shower room must be repaired together with the damage this had caused to the office downstairs. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 6 The registered person should consider the occupational therapist report in relation to the bathroom. An assisted bath should be provided so that residents have a choice of bathing facilities and access to a shower and a bath. An application must be made to the Commission to register a home manager. 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. Webb Road (1a) DS0000066976.V284427.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 Webb Road (1a) DS0000066976.V284427.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): 2. As no new residents had been admitted since the introduction of the National Minimum Standards it was not possible to assess how this process would be managed. EVIDENCE: Management were aware of their responsibility to assess service users prior to admission. No new service users had been admitted since the introduction of the National Minimum Standards. It was therefore not possible to assess how this process would be managed. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6. Care plans seen reflected how resident’s needs were being met, included risk assessments but did not reflect resident involvement nor had these been signed, dated or include a review date. EVIDENCE: Two care plans were inspected. These were written using words and pictures and provided details as to how care needs were to be met. The care plans included a front sheet indicating the resident was unable to sign their agreement. As a number of service users have good relative support efforts must be made to include them in care planning and decision-making. At the last inspection it was noted that care plans had not been signed, dated or included a review date and this situation remained unchanged. Requirement 1 and recommendation 1. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 and 17. Residents were supported to attend day centres, participate in local leisure activities and to maintain family contact. The menu displayed showed residents were provided with a varied diet. EVIDENCE: Residents attended day centres where they had the opportunity to develop personal interests and life skills based on individual ability. Staff ensured residents had the opportunity to access local leisure services. An activity diary was kept and showed residents had the opportunity to go to football matches, visit local pubs, have meals out, go to the cinema and enjoy home entertainments. Two residents were in the home during the inspection but neither could give their views on the activities provided or organised for them. Staff said all but one resident had relative support and some residents made regular home visits. The one resident without relative support had been referred to the advocacy service, as the befriender they had was no longer involved. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 11 A four weekly menu was prepared. This showed that a varied diet was provided. Residents had a take-away meal once a week, which staff said they enjoyed. A cook was employed to prepare the evening meal from Monday to Thursday and staff prepared meals at other times. Foods were stored correctly and food, fridge and freezer temperatures recorded daily. The kitchen cupboards were clean and tidy but the oven and extractor needed cleaning. Requirement 2. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20. Medicines were generally well managed but attention was needed to ensuring policies and procedures were adequate and medicines were stored correctly and hygienically. EVIDENCE: None of the residents managed their own medicines. The home had policies and procedures in relation to medicine management. These were last reviewed in June 2002 but did not include procedures for the disposal of medicines, leave medicines or management of medicine errors. Medicines were safely stored in a secure area of the laundry room. The laundry room was quite warm and at the last inspection it was recommended that staff monitored the temperature of this area. A thermometer had been provided but temperatures had not been recorded. A medicine trolley was provided for use when administering medicines. The metal medicine cupboard fixed to the wall was in need a good clean. Since the last inspection medicines were supplied in blister packs with preprinted administration records. Medicine records were well maintained and supplies checked were correct. No homely remedies were in stock except for those one resident and this had been agreed with the GP. Internal and external medicines were stored together. Requirements 3 and 4. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22. A complaints policy and procedure was provided. No complaints had been recorded since the last inspection despite relative feedback saying they had reason to complain. EVIDENCE: No complaints or adult protection allegations had been made to the provider or the Commission since the last inspection. However feedback received from relatives indicated complaints had been made about aspects of care. No complaints had been recorded in the home. Staff displayed a good understanding of adult protection and how to manage an allegation of abuse. Requirement 5. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 and 30. Most of the environment was maintained to an adequate standard and suited to meeting the needs of the current residents. Areas that needed attention were the bathing facilities, the leak from the shower room and the damage this had caused. EVIDENCE: Communal areas were clean and tidy but please see the comments under standard 17. Since the last inspection new sofas and an armchair had been provided for the lounge. Three bedrooms had been decorated since the last inspection and the residents supported to purchase new and suitable furniture. Bedrooms seen were personalised to reflect the resident’s interest. The shower room floor was leaking by the door and water leaked down to the manager’s office. This had been going on for some time and must be addressed. An occupational therapy assessment had been completed on the bathroom. The bath provided was not suitable for all of the residents. In fact only one resident could easily use this facility. The report recommended the purchase of a new assisted bath, which could be used by all the residents. Requirement 6 and recommendation 2. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 33, 34, 35 and 36. Adequate staffing levels were maintained and staff received regular supervision. Staff were recruited as required by regulation. EVIDENCE: Staff rotas seen showed adequate staffing levels were maintained. Recruitment policies and procedures were provided. Three staff files were inspected and found to comply with regulation. Since the last inspection staff had access to training such as food hygiene, health & safety, fire safety and moving & handling. Staff who spoke to the inspector confirmed they received training relevant to their role. Records seen showed staff received regular supervision. Staff confirmed they received and benefited from supervision. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 16 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 and 42. The home has not had a registered manager for some and an acting manager was in post. Attention was given to ensuring a safe environment was provided for residents and others. EVIDENCE: The home has not had a registered manager for some time and the acting manager had accepted the manager’s post. He had applied to the Commission to become the registered manager. Minutes of staff and relative meetings were seen. The staff meetings did not indicate there had been input from the care staff. In view of the ability of the residents it would not be practical to hold resident meetings therefore efforts were made to involve relatives in decision-making. A selection of safety records were inspected. These showed attention had been given to maintaining and servicing safety systems. Safety records seen were up to date. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 17 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 2 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 3 3 3 X X 3 X Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15 Requirement The Registered Person must ensure staff sign, date and include a review date in care plans. (Timescale of 14/10/05 was not met.) The Registered Person must ensure equipment provided iswell maintained. A system must be put in place to ensure the oven and extractor fan in the kitchen are kept clean at all times. The Registered Person must ensure the safe management of medicines. The homes medicine policies and procedures must be reviewed to include the use of homely remedies, leave medicines and management of drug errors. The temperature of the medicine storage area must be monitored. (Timescale of 14/10/05 was not met.) The Registered Person must ensure the safe management of medicines. Internal and external medicines must be stored separately. DS0000066976.V284427.R01.S.doc Timescale for action 17/04/06 2 YA30 23 17/04/06 3 YA20 13 17/04/06 4 YA20 13 17/04/06 Webb Road (1a) Version 5.1 Page 19 5 YA22 17 6 YA27 23 Medicine storage cupboards must be kept clean and hygienic. The Registered Person must ensure records are kept for all complaints made about the service and show how these had been managed. (Timescale fo 14/10/05 was not met.) The Registered Person must ensure the home is adequately maintained. The leak from the shower room must be addressed and the damage caused repaired and redecorated. 17/04/06 17/04/06 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 2 Refer to Standard YA6 YA27 Good Practice Recommendations The Registered Person should ensure care plans reflect that relatives were involved in preparing these. The Registered Person is strongly recommended to replace the bath as recommend in the occupational therapy report and ensure residents have a choice of bathing facilities. Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Webb Road (1a) DS0000066976.V284427.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!