Inspection on 25/01/06 for Wheathill Road, 19

This inspection was carried out on 25th January 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wheathill Road, 19 16/11/07

Wheathill Road, 19 26/09/06

Wheathill Road, 19 01/09/05

Wheathill Road, 19 07/12/04

Wheathill Road, 19 04/05/04

Wheathill Road, 19 20/11/03

Wheathill Road, 19 01/09/03

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Wheathill Road, 19 19 Wheathill Road Penge London SE20 7XQ Lead Inspector Miss Rosemary Blenkinsopp Unannounced Inspection 25th January 2006 10:00 Wheathill Road, 19 DS0000006907.V278899.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 Wheathill Road, 19 DS0000006907.V278899.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. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wheathill Road, 19 Address 19 Wheathill Road Penge London SE20 7XQ 020 8659 7425 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) Community Options Limited Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 Adults of either sex with a mental disorder (within the category MD) Date of last inspection Brief Description of the Service: The home is a large house located in a residential area of Penge. The facility is part of the Community Options group, which operates the home, whilst Hyde Housing owns the building. The home is for five residents who have long-term mental health problems. The main purpose of the home is rehabilitation into the community, with residents developing the skills for more independent living. Residents are encouraged and supported to be independent in all activities of daily living. In addition integration into the local community and accessing local services including health provision is promoted. The home has its own staff team with a manager and deputy heading up the team. Senior management and personnel are provided through the head office of Community Options. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted as an unannounced visit. Those standards, which were not assessed at the previous inspection on 1 September 2005, were addressed. In addition the progress on previous requirements was monitored. Arising out of this inspection were three requirements of which two were outstanding from previous inspections. At the time of the inspection there were two residents up and they met with the inspector. Positive comments were received regarding the home the staff group and the support which they received. Two staff were on duty including the deputy manager Victor Tandi who facilitated the inspection process. The documentation inspected included care plans, water temperatures, Statement of Purpose, some health and safety records and Regulation 26 visits. Generally the findings of the day were found to be satisfactory with the exception of care plan records. What the service does well: What has improved since the last inspection? What they could do better: There has been a change of manager since the last inspection, and over recent years, the change of manager has occurred frequently. This is not beneficial either to the residents in the home or the staff group working within it. A meeting with Community Options management identified this as an issue and it is hoped that future management changes will be kept to a minimum. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 6 Again the care plan documentation and risk assessments for residents were insufficient and not reflective of the fact that these residents suffer from mental health problems, live in a mental health facility and are under the Care Programme Approach. Problems identified within care plans were reflective of the residents’ physical heath needs and limited on other areas. This has been discussed on a number of occasions and action must be taken to address this. 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. Wheathill Road, 19 DS0000006907.V278899.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 Wheathill Road, 19 DS0000006907.V278899.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): 1. The Statement of Purpose is not currently accurate in relation to the staff group. In addition, the registration for the home needs to be amended to accurately reflect the residents within it. EVIDENCE: The Statement of Purpose will need to be amended to reflect the new manager. The deputy manager is due to move to another Community Options facility and therefore details of the staff group will also need to be amended. The registration certificate will need to be amended to include a variation for that resident who is above the age range of 65 years as she is currently 71 years. This has been previously discussed and this was referred to Mr John Cribbens, Community Options, for action. Please see repeated requirement 1. Wheathill Road, 19 DS0000006907.V278899.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): 6,10 Care plans and associated risk assessments are not sufficiently detailed or comprehensive in content to reflect all of the residents’ needs particularly their mental heath issues. Without robust care plan and risk assessment documentation, staff would be unable to provide support in a consistent manner. EVIDENCE: Care plans are securely stored in the staff office, which is lockable and is locked whenever staff are not in it. The resident who had been admitted in August 2005, and was subsequently transferred back to hospital with a few days of admission, was now back in the home. He had remained in hospital for a significant period of time having returned to Wheathill Road 5/12/2005. The care plan for this resident was inspected. The documentation contained contact details of his next of kin, CPA coordinator and other significant persons involved with the resident. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 10 Several of the Community Options forms had not been completed, the staff stated that the resident himself was unable to concentrate, nor had the interest in completing these. He was described as having a short attention span and unable to engage in activities. The support plan reflected none of his mental health issues, detailing personal hygiene, improved diet, and a reduction in cigarette and sugar consumption as his only problems. Within the file there was a CPA care plan with outlined his mental heath needs, in addition a form headed “Adult Panel Procedures for Mental Health” did give some information relating to his mental health. Staff within the home need to incorporate, amend and expand upon this resident’s care plan to reflect this information and detail the interventions to take, particularly his mental health issues. Care plans must accurately reflect all of the residents needs including physical, mental, social, psychological and spiritual. The resident’s risk assessment included items such as self-neglect, poor nutrition, finances, missing persons and fire. Again there was nothing to reflect the risks posed by his mental heath condition. It is particularly concerning as this resident had relapsed very quickly when initially admitted to Wheathill Road and, from information provided by staff, he was still having significant problems with concentration, orientation, memory and activities of daily living. The inspector was advised that this resident would only take his medication crushed in honey. This was not reflected in his support plan. In the event that medications are being disguised and not administered in their original form, full discussion with the multi disciplinary team and the resident themselves needs too take place, with a decision clearly documented, kept under frequent review and amended should the situation change. The inspector was advised that the resident himself was fully aware of the fact that medication was in the honey. Please see repeated requirement 2. Please see recommendation 1. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11. Daily lives and activities are focused on rehabilitation of the resident to facilitate more independent living. EVIDENCE: The majority of residents are involved at some level with their own shopping, cooking and daily household chores. This is part of their ongoing rehabilitation. One resident with whom the inspector had met at the last inspection was discussed with staff. It was apparent that this resident was still not engaging with other residents or the daily living activities, which form the basis for rehabilitation and more independent living. The focus of this home is rehabilitation and this situation has gone on for a considerable period of time. In addition the inspector was advised that she remained uncooperative with reviews and appointments. This resident is a known epileptic and has on various occasions taken alcohol, which may compromise the effects of her anti epileptic medication. This had been confirmed by one of her doctors. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 12 The home operates a no alcohol policy and reference to this is included in the contract issued to residents. In the event that this resident continues to be provided with, and consume alcohol on the premises, then the home’s policy and contract on alcohol, needs to be reviewed. The home should undertake a review of the resident’s needs, particularly in view of her rehabilitation to ensure that she is suitably placed. There was information relating to her epilepsy pinned to the office wall, however this needs to be formulated into a care plan detailing all actions to be taken. A supporting risk assessment needs to be in place when she is taking alcohol due the effects this may have on her epilepsy and an increase in frequency of seizures. Please see requirement 2. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: No standards were assessed in this section. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 14 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): EVIDENCE: No standards were assessed in this section. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 15 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 The areas inspected were domestic in style and maintained in a homely manner. EVIDENCE: No individual bedrooms were inspected. The only areas which were toured, were the kitchen and the lounge area. Both were clean and tidy. One of the kitchen cupboard doors was missing; this was waiting to be replaced by the housing association who deal with the building Hyde Housing. Fridge / freezer temperatures were in place. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 16 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): EVIDENCE: No standards were assessed in this section. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 39,42 Health and safety measures are in place for the protection of residents and staff in the home. EVIDENCE: The employer’s liability insurance certificate was on display up to five million pounds covering a period up to 24 November 2006. A limited selection of health and safety records were inspected and found to be satisfactory. The fire risk assessment had been documented 2 September 2005 and the health and safety signed by the Chief Executive was dated 5 September 2005. The record of hot water temperatures had been changed from weekly to monthly it was unclear why this had occurred. The hot water temperatures checked were cooler rather than hot. Some of the temperatures recorded were above 43 degrees Celsius. The deputy manager stated that if this was Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 18 identified then it was immediately reported to Hyde Housing although the response was sometimes slow. If temperatures are found to be higher than those accepted the area should, where possible be taken out of action and additional risk assessments put in place. The water risk assessment was dated 14 November 2003, it should be confirmed that the home meets the appropriate regulations for Legionella inspecting. It was noted that the records stated that the central heating had been down for a two-week period 9 October – 23 October 2005. The CSCI should have been advised of this by way of a Regulation 37 report. The accident book was data protection compliant and all records stored appropriately. Regulation 37 reports relating to accidents/incidents are forwarded to the CSCI. Regulation 26 reports were available although the last one was dated 24 November 2005 and prior to this generally two monthly, these need to be conducted monthly. Please see requirement 3. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 19 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 2 2 X 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X 3 LIFESTYLES Standard No Score 11 2 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X 2 X X 2 X Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4 Requirement The Registered Provider must ensure that the Statement of Purpose includes all information as detailed in Schedule 1, Care Standards Act 2000, which is accurate. All residents must be within the registration category and age range. Variation must be sought for the resident above the age of 65. Previous time frame for action 31/12/05. This is now outstanding. The Manager must ensure that all care plans are reflective of needs, with risk assessments and all supporting documentation in place, current and kept under review. Previous time frame for action 30/09/05. This is now outstanding. Timescale for action 28/02/06 2. YA6 15 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 21 No. 1. Refer to Standard YA20 Good Practice Recommendations The Manager should ensure that all appropriate professionals are involved, in the event that medication is disguised in foodstuffs and not administered in its original form. Wheathill Road, 19 DS0000006907.V278899.R01.S.doc Version 5.1 Page 22 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. 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