Care Home: Bungalow (The)

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What the care home does well "Well fed and well looked after", "I have been generally pleased over the past five years in the way the bungalow is run" and "the staff do very well with the facilities at hand" were comments from relatives or friends of people living at the home. Staff have good access to training which benefits the people who live there. Medication is well managed by the service. What has improved since the last inspection? The issues raised at the September 2006 inspection have all been addressed. These included making sure that regular Fire Safety checks take place and that care plans are fully reviewed every six months. A relative or friend said that they thought staff now have better access to training and there is more continuity for the people living there. What the care home could do better: The main communal areas are in need of re-decoration. We have made some recommendations for the home to look at how it can make things like menus, staff rotas and the complaints procedure more user friendly for the people living there. CARE HOME ADULTS 18-65 Bungalow (The) The Bungalow 325 Larkshall Road Chingford London E4 9HW Lead Inspector Jon Fry Unannounced Inspection 14th January 2008 10:50 DS0000007272.V357849.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 DS0000007272.V357849.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. DS0000007272.V357849.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bungalow (The) Address The Bungalow 325 Larkshall Road Chingford London E4 9HW 020 8523 3264 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) r.asamoah@mcch.org.uk www.mcch.co.uk MCCH Society Ltd Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000007272.V357849.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2006 Brief Description of the Service: 325 Larkshall Road, also known as The Bungalow provides accommodation and support for up to six people who have a learning disability. The home is situated in the Chingford area of the London Borough of Waltham Forest, and is close to local amenities and transport links. The service is run by MCCH Society Ltd, a not for profit organisation which operates a number of residential homes in London and the South East. The home was purpose built and provides single room accommodation, with shared communal space and bathrooms. DS0000007272.V357849.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 the people who use this service experience good quality outcomes. We spent just over four hours at the home. Five people who live there were present at the time we visited and one person told us what they thought about their home. We spoke to three staff members and looked at care plans, staff files and the home’s User Guide. Completed surveys were received from three relatives or friends of people who live at the home. The home completed an Annual Quality Assurance Assessment (AQAA) to tell us about the service provided, how it makes sure of good outcomes for the people using it and any planned developments. What the service does well: What has improved since the last inspection? What they could do better: The main communal areas are in need of re-decoration. We have made some recommendations for the home to look at how it can make things like menus, staff rotas and the complaints procedure more user friendly for the people living there. DS0000007272.V357849.R01.S.doc Version 5.2 Page 6 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. DS0000007272.V357849.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 DS0000007272.V357849.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, 2 and 3. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally good information is available to people about the home. The needs of people using the service are assessed to make sure that they can be met. EVIDENCE: Two of the three relatives or friends who returned surveys said that they felt the home ‘always’ met the needs of the individual. One person said ‘usually’. One comment was “they have got much better over the past two years”. A Statement of Purpose and User Guide are available and these give information about the home. We saw that these documents need minor updates around management and staff names. The User Guide is available in a symbol format. We have recommended that this document could also be produced with actual photographs of the home, the staff that work there and local facilities. There are five people currently living at the home. One person has moved to more suitable accommodation since the September 2006 inspection visit. DS0000007272.V357849.R01.S.doc Version 5.2 Page 9 The service has an admissions procedure. Any person coming to live there is able to visit as part of a planned process. We saw that assessments had been carried out before individuals came to live at the home. Good quality comprehensive information is kept on file for each person living there. DS0000007272.V357849.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, 8 and 9. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans give good information about the support needs of people using the service. Individuals are supported to make choices in their daily lives. EVIDENCE: We looked at the care plans for two people who live at the home. These were very comprehensive and recorded good quality information about the support needed by each person. Each person has a communication passport that contains good clear person centred information under headings such as ‘things I can do’ and ‘things I need support in’. The home keeps individual risk assessments on file for each person. We saw that these are generally kept under review although we did see some assessments where a planned review had not taken place. DS0000007272.V357849.R01.S.doc Version 5.2 Page 11 Staff complete regular evaluations of the care plan and these also document what the person has been doing socially along with their current health and care needs. We have recommended that the evaluations could also document progress in achieving goals set at the person’s six monthly reviews and also to check that risk assessments are up to date. Weekly meetings are held where the people living there are consulted about things like the menus and the planning of social events and trips. This is a good opportunity for people to be involved in the running of the home. We saw staff giving individuals choices about what they wanted to eat and in making plans for the day ahead. DS0000007272.V357849.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): 11, 12, 13, 14, 15, 16 and 17. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are able to enjoy a good range of activities of their own choosing. EVIDENCE: Comments from relatives or friends in surveys included “they get out in the community and go on holiday” and “since my relative moved to Larkshall Road, they have had a much fuller life”. People who live there access day services during the week. We saw that the home also supports individuals to enjoy a good range of activities and outings. These include outings to shops and cafes, swimming and the cinema. DS0000007272.V357849.R01.S.doc Version 5.2 Page 13 The organisation has a two monthly forum for people who live in the homes it runs and there are regular social activities arranged. In the past these have included barbeques, parties and trips out. One person has their own transport. The home has recently been given the go ahead to buy another vehicle to be shared by the other people living there. One person we spoke to said “the food’s nice”. The menu is written each week with the involvement of individuals. The senior staff member told us that they are developing the menus to be more user friendly by using pictures of different meals. We have recommended that the home look at alternatives to the use of plastic aprons. These looked very clinical when we saw them in use on the day we visited. DS0000007272.V357849.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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good support is in place to meet individual health needs. Medication is well managed. EVIDENCE: Care plans include information on the support needs of people using the service and how these needs are to be met. Staff are aware of individual health needs and how these are to be met. People living there are supported to see their GP or other healthcare professionals as required. We saw that full records are kept of these appointments. Good medication policies, procedures and practices are in place. Staff receive training in administering medication and medicines are labelled and stored correctly. We saw that Medication Administration Record Sheets are kept up to date and signed by staff. There is a system to make sure that medication is DS0000007272.V357849.R01.S.doc Version 5.2 Page 15 regularly audited and this clearly works to make sure that people receive their medication as prescribed. During our visit, PRN (as needed) medication was being given to one person living there. This medication did not appear to be effective and we have recommended that the home reviews this with the prescriber. DS0000007272.V357849.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear complaints procedure that is accessible to the people who use the service and their relatives or representatives. Individuals are protected from harm. EVIDENCE: Relatives or friends of individuals who returned surveys all said that they knew how to make a complaint and were confident that the service would respond positively to any issues raised. The home has a clear complaints policy, which includes the timescales and the process of any investigation. No complaints have been received in the last twelve months. The complaints procedure is displayed in the hallway and has been made slightly more accessible to the people living there by the use of some pictures. We think that this could be made even more user friendly by using bigger print and photographs of staff. Staff are trained in Safeguarding Adults and procedures for them to follow are available. DS0000007272.V357849.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, 26 and 30. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home environment is generally satisfactory but the communal areas need some re-decoration. EVIDENCE: We saw that the home generally provides a comfortable, clean and homely place for people to live. The communal areas of the home need re-decoration and the home has already identified this as something that needs doing in the short term. One relative or friend who completed a survey said that they thought the garden could be improved “so staff and relatives can sit out with people in the Summer”. DS0000007272.V357849.R01.S.doc Version 5.2 Page 18 There are enough bathrooms and toilets available with a choice of shower or bath. Bedrooms are single and have been personalised to the individual’s choice. DS0000007272.V357849.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): 31, 32, 34, 35 and 36. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have good training opportunities. The staff recruitment process is good and ensures that appropriate checks are made. Regular staff supervision and staff meetings take place. EVIDENCE: One person who lives there told us that the staff were ‘alright’. Comments from relatives or friends of individuals included “the staff are supportive” and “I’ve always found the staff very helpful”. There are three staff on each shift during the day. Two staff are at the home overnight with one person awake and the other person sleeping on the premises as an on-call. A male staff member is always working on each shift. We have recommended that the home consider displaying photographs of staff in a communal area to show the people who live there who is going to be on duty. DS0000007272.V357849.R01.S.doc Version 5.2 Page 20 Staff we spoke to said that they have good training opportunities. Comments from individuals included “I can’t fault it” and “you name it, I’ve had it”. Current training courses included medication, person centred planning and food hazard analysis. Staff also have access to an NVQ training programme. Two new staff have recently started work and we saw that they were undertaking their induction training. This includes First Aid, Food Hygiene and Fire Safety. Recruitment records are well kept and show that staff have all the necessary checks before they start work. These include suitable references, proof of identification and a Criminal Records Bureau (CRB) check. All the staff we spoke to said that they received regular supervision with their line manager. DS0000007272.V357849.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, 38, 39 and 42. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run well. Good Health and Safety arrangements are in place. EVIDENCE: The previous registered manager no longer works at the home and a new manager is in post. She has good experience as a manager in social care and has applied to be registered with the CSCI. The organisation provides management training and the manager is currently undertaking a management development course. DS0000007272.V357849.R01.S.doc Version 5.2 Page 22 We saw that good systems are in place to make sure that records are kept up to date. As stated previously, medication records are very well kept by staff and audited regularly. As well as regular meetings, quality assurance procedures include six monthly questionnaires for the people who live there. An annual development plan is in place and the service is working on further questionnaires to send out to relatives and representatives. We saw that regular Health and Safety checks are carried out to protect the welfare of people using the service. Good records are kept of these. DS0000007272.V357849.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 3 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 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 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 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 X 3 3 3 X X 3 X DS0000007272.V357849.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) Requirement The communal areas of the home need to be re-decorated. This is to make sure that the people living there live in a homely well-maintained environment. Timescale for action 01/06/08 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 YA1 YA6 Good Practice Recommendations The User Guide should be made more user friendly by using photographs / pictures. The regular evaluations completed by staff could include a review of the goals in place for the individual. Risk assessments could also be reviewed to see if there are any changes needed. The home should continue to develop the menus in a picture format. The use of white plastic aprons should be reviewed. The PRN medication of one person should be reviewed to make sure it is effective. This was discussed during our visit. DS0000007272.V357849.R01.S.doc Version 5.2 Page 25 3. YA17 4. OP20 5. 6. YA22 YA33 The complaints procedure could be made more user friendly for the people living there. The home should consider displaying the rota in a picture format so that the people who live there can see who is on duty. DS0000007272.V357849.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 DS0000007272.V357849.R01.S.doc Version 5.2 Page 27 - 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. 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