Care Home: Alma Grove, 1a

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What the care home does well Alma Grove provides a homely environment for the people who live there. We saw staff interact positively with the people living there. Staff know them well and how best to communicate with individuals. People make choices about what they do and are involved in planning for their future. Staff said they receive relevant training to meet people`s needs. They also said the service meets peoples needs and promotes peoples choice. Staff said the service deals with health and safety issues very well, keeping people and visitors safe. What has improved since the last inspection? The Statement of Purpose has been updated to include details of the fees, ensuring people who use the service are aware of what they pay for. The manager told us that people who use the service no longer pay for transport services they do not receive. People who use the service have been involved in purchasing pictures and belongings for their bedrooms and are happy with the pictures in communal areas of the home. The manager told us that there are still some staff vacancies, although regular bank staff cover the positions, to allow flexibility to the service. All staff have been receiving regular supervision, ensuring they are supported and have the opportunity to develop their skills. The manager told us that a new staff appraisal format is in place, which gives staff and the manager the opportunity to detail any training requirements. The manager has registered with the CSCI. These issues were raised at the last inspection of the service. The service has developed communication passports for the people who live there, providing staff with information about the ways to communicate with individuals to best meet their needs. Communal areas and some bedrooms have been redecorated to the individuals and groups choice. What the care home could do better: The issues with the heating in the lounge must be addressed to ensure the home is warm enough for the people who live there. Two members of staff told us that having a full staff team and not using agency staff would improve the services provided. CARE HOME ADULTS 18-65 Alma Grove, 1a Bermondsey London SE1 5PY Lead Inspector Emma Dove Key Unannounced Inspection 8th January 2009 11:30 Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alma Grove, 1a Address Bermondsey London SE1 5PY 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 7231 2316 020 7231 2316 billy@odyssey-csft.org www.odyssey-csft.org Odyssey Care Solutions for Today Philomena Mary Phillips Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 3 20th September and 6th October 2006 Date of last inspection Brief Description of the Service: Alma Grove is a registered care home for up to three adults with learning disabilities. Three people are currently living there. The service is managed by Odyssey Care Solutions who have other, similar homes in Southwark. The home is a two-storey house in a residential road in Bermondsey. There is a small garden at the back and on street parking at the front. It is near to small local shops and leisure facilities. Bus routes pass near to the home, whilst a tube station and main line station are about a fifteen-minute walk away. The weekly fees are from £1797. Information about the CSCI is included in the Statement of Purpose and Service Users Guide. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. This unannounced inspection was carried out over four and a half hours on the 8th January 2009, by one regulation inspector. We spoke with people who use the service, staff, the manager and looked at records. Surveys were sent to relatives of people who use the service and placing social workers. We have received three completed surveys, comments from which are included throughout this report. We received an annual quality assurance assessment (AQAA) from the manager in October 2008. This gave us good information about the service, what is does well and areas that will be developed over the next year. We also looked at other information received from the service since the last inspection in September and October 2006. What the service does well: What has improved since the last inspection? The Statement of Purpose has been updated to include details of the fees, ensuring people who use the service are aware of what they pay for. The manager told us that people who use the service no longer pay for transport services they do not receive. People who use the service have been involved in purchasing pictures and belongings for their bedrooms and are happy with the pictures in communal areas of the home. The manager told us that there are still some staff vacancies, although regular bank staff cover the positions, to allow flexibility to the service. All staff have been receiving regular supervision, ensuring they are supported and have the opportunity to develop their skills. The manager told us that a new staff appraisal format is in place, which gives staff and the manager the opportunity to detail any Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 6 training requirements. The manager has registered with the CSCI. These issues were raised at the last inspection of the service. The service has developed communication passports for the people who live there, providing staff with information about the ways to communicate with individuals to best meet their needs. Communal areas and some bedrooms have been redecorated to the individuals and groups choice. 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. Alma Grove, 1a DS0000060222.V373739.R01.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 Alma Grove, 1a DS0000060222.V373739.R01.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): 1 and 2 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. Admissions are only made after an assessment of need has been completed to ensure that the service is appropriate for the individual. EVIDENCE: The service has developed information for people looking to move into the home. This information helps people make the decision to move in. The Service Users Guide details the accommodation provided, how care will be supplied and the review process, information about the local community, financial details, how to make a complaint and staff who work at the service. This document needs updating to reflect the current staff group and details of the CSCI. There have been no new admissions since the last inspection in September 2006. People said they are ‘happy here’, ‘been here a while’ and ‘I get on alright with the others’. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 9 We didn’t see assessments from when people first moved in, because this was many years ago. We did see care plans include the care, support and assistance individuals need. The manager told us that the people who live at the service are having their needs re-assessed. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service are involved in planning their care, developing care plans and making decisions which affect their future. Care plans are person centred. Staff have the ability and skills to meet peoples needs. Risk assessments are in place. EVIDENCE: We saw care plans, these documents are person centred and focus on the care, support and assistance the individuals need and want. People told us they do the things they want and make choices about what they do. We saw that people have goals they are working to achieve. One person said having a goal is important to them. The service has developed communication passports for each person. These Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 11 documents help staff understand the ways people communicate and means they can provide better support to individuals. Staff said they have enough information to meet people’s needs. We saw risk assessments completed, taking into account the need to balance safety and allowing people to live fulfilling lives. People told us they feel safe. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a commitment to enabling people who use the service to maintain and develop their social, emotional, communication and independent living skills. EVIDENCE: The manager told us they support people to live the lives they choose. People told us they choose what they do and where they go. People told us they keep in contact with family and friends and can have visitors to the home and go out in the local community. We saw that people were out for the day and with staff doing the weekly food shop and shopping for personal items during our visit. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 13 The manager told us that the people who use the service chose to go on holiday to the Isle of Wight last year and have indicated that they want to go there again this year. People confirmed that they were involved in choosing where they went on holiday last year and have talked about it with staff this year. We saw a varied menu which takes into account peoples preferences and cultural or medical requirements. People told us they ‘enjoyed lunch’, ‘like going shopping’, ‘help cook meals’ and ‘like the food’. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People receive support with personal and health care using a person centred approach. People’s health care needs are well met. Medication is well managed. EVIDENCE: We saw case files include a health action plan, which details the individuals health care needs and support. We saw good records of health care appointments and any actions to be taken. Medication is appropriately stored, labelled and records are up to date and signed by staff. Good systems are in place to check medication has been administered every day. Staff complete medication training to help them administer medication according to the policies and procedures. Alma Grove, 1a DS0000060222.V373739.R01.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 and 23 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a clear complaints procedure which is accessible to the people who live there. Appropriate policies are in place for safeguarding and staff have completed training and are aware of their responsibilities. Good systems are in place to monitor peoples finances. EVIDENCE: The manager told us that people who use the service have the opportunity at residents meetings to raise concerns and that any concerns are taken seriously and investigated following the procedures. No issues were raised during this visit. The manager reported one complaint in the last year which was dealt with using the procedures and not upheld. We saw records include the actions taken during the investigation and the outcome. We have not received any concerns or complaints since the last inspection of the service in October 2006. Staff said they are aware of how to respond to complaints and concerns raised by people who use the service or their representatives. The organisation has appropriate safeguarding procedures. Staff confirmed Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 16 that they have completed training in safeguarding and are aware of their responsibilities. The manager told us the service holds some money for individuals. We saw the records and balance for one person was up to date and correct. We saw staff checking records and balances during our visit, they said this is done every day. People who use the service told us that staff help them with their money and they feel they get the right help and that their money is safe. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home is appropriate to meet the needs of the people who live there. People have their own bedrooms which they decorate as they choose. The home is well maintained and kept to a good standard with the exception of the heating. EVIDENCE: People have access to a kitchen/dining room, lounge, games room, laundry area, bathroom with toilet and staff sleep in room/office on the ground floor. All three single bedrooms, a second bathroom with toilet and staff office are on the first floor. People told us they ‘like my room’, ‘got all I need in my room’, ‘play snooker in the games room’ and ‘buy what I want for my room’. There are sufficient bathrooms and toilets with the choice of bath or shower. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 18 During our visit, we saw one person tell staff they were cold. They responded appropriately and advised the person to put another layer of clothing on. The manager told us they have had new heating system with smaller radiators in the lounge that ‘don’t seem to keep the room properly heated’. They have reported this and had engineers visit the home but the lounge is still cold. We agreed that the room was cold. This must be sorted to ensure people are not cold and have to leave the lounge when the weather is bad. All areas were clean and fresh. The manager told us they are planning to get people who use the service to be more involved in the day to day cleanliness of the home, particularly bedrooms. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 19 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 and 36 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People have confidence in the staff who support them. Staff levels are sufficient to meet peoples needs. Staff recruitment is in line with regulations to keep people safe. Staff have access to training and have regular supervision from the manager. EVIDENCE: We saw enough staff to meet peoples needs, with two staff in the morning and afternoon and the manager in addition to this most week days. The staff rota is available in pictorial format, which makes it accessible to the people who use the service. Staff said there are ‘always’ and ‘usually’ enough staff to meet peoples needs. Two staff did comment that having more permanent staff would enable them to offer a better service to the people who live there. This was discussed with the manager who said they have two vacant posts which they use flexibly to provide cover. The organisation has a bank/locum staff group who cover staff Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 20 holidays, training and vacancies and this helps provide a consistent service for the people who live at the home. Staff said they had the appropriate checks before they started work at the home. Staff recruitment records are kept at the organisations head office. We saw a record sheet of the checks completed before staff started work including references received and a Criminal Records Bureau check. Staff said their induction covered everything they needed to know ‘very well’ and ‘mostly’. The manager said staff do an induction to the organisation and at the home, which covers the individual needs of the people who live there and the policies and procedures staff must follow. Staff said they have access to training appropriate to their job and to help them provide the right care and support to people who use the service. Two staff have completed NVQ to level 3 and two staff are currently doing this training. Staff said they received support to help them carry out their job. Staff told us that they ‘regularly’, ‘often’ and ‘sometimes’ met with their manager. The manager said she sees staff on a regular basis for supervision and they have staff meetings and a daily handover. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 21 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 and 42 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager has the experience needed to run the home. The service is well run, in the best interests of the people who live there. The annual quality assurance assessment included clear information about what the service does well with evidence to confirm this. Health and safety is well managed with records up to date. EVIDENCE: The manager has been at the home for over two and a half years and has many years experience in similar services owned by the organisation and with another organisation. She has registered with the CSCI. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 22 The service has an action plan for 2008/2009 which is being worked to by the staff team. Good systems are in place to monitor the quality of the services provided. A representative from the organisation visits every month and speaks with people who use the service, staff and checks some records. The manager sent out surveys to relatives and other stakeholders in November 2007. Comments received were positive with no issues raised. The manager said they have regular meetings with the people who use the service, to ensure their views are respected and any requests are met. People told us they are involved in what happens at the home. The manager told us all health and safety checks are up to date and carried out at the appropriate intervals. We saw records confirming the fire alarm is tested weekly, the portable electrical appliances and gas safety were checked in February 2008. Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Alma Grove, 1a DS0000060222.V373739.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23 (2) p Requirement The issues with the heating in the lounge must be addressed to ensure the room is warm enough for people to sit in. Timescale for action 19/02/09 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 YA12 Good Practice Recommendations Consideration should be given to providing a computer for people who use the service, with internet access and other visual media equipment to enhance their communication development. 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