Care Home: Camilla Road, 64

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What the care home does well There are enough staff to look after the service user well. The staff are well trained. The medication is looked after well. When the service user needs to see someone about her health this is arranged for her. The staff know the service user well, they know which activities she likes and, whenever possible help her to do them. What has improved since the last inspection? We did not ask that any improvements be made at the last inspection. What the care home could do better: The home should make sure that when the service user needs transport to go out this is provided, whenever possible. If there are dangerous items in the home they must be kept safely. The bath aid which the service user does not need should be removed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Camilla Road, 64 Camilla Road, 64 London SE16 3NJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Pritchard     Date: 0 5 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Camilla Road, 64 Camilla Road, 64 London SE16 3NJ 02072520074 02082998598 choicesupport@choicesupport.org.uk www.choicesupport.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Choice Support care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 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 category: Learning disability Code LD Date of last inspection Brief description of the care home 64 Camilla Road is a care home, registered to provide personal care and accommodation for three people with a learning disability. Choice Support, a voluntary organisation, manages the service and provides the care. The building is owned by Habinteg Housing Association. The home is located in Bermondsey, close to shops, pubs, the post office and other amenities. The home consists of single storey building, providing wheelchair access to all parts of the home. All of the homes bedrooms are single. There is a garden to the rear. There is currently one service user at the home. Prospective service users and their relatives/friends would be given the Service User Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 Brief description of the care home Guide. A copy of the most recent CSCI inspection report is available on file at the home. Information about current fees are obtainable from the Choice Support Head Office. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We did not tell the home that we were going to inspect. When we went to the home we talked to staff, looked at files and talked to the service user. The home had given us information before we got there and we used this to find out more about the care they give. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions to the home are made on the basis of both the potential service user and the home having enough information to make a decision about its suitability. There are some errors in the statement of purpose which need to be corrected, this should be easily achieved. Evidence: We saw a statement of purpose for the home. It is written in plain English with symbols and photographs. It is designed to be accessible to people with learning disabilities. The document needs to be amended as we saw some errors in the information. The errors included the statement that there are two bedrooms, in fact there are three. In addition it stated that the home is registered for one person, in fact it is registered under the Care Standards Act to provide care for three people. There is just one service user living at the home, she moved in approximately one year ago. We discussed her admission to the home with the staff on duty and looked at relevant paperwork. We found that there was a gradual introduction to the home for the service user. The introduction took place over a period of months and involved Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: visits and overnight stays. The service users family members also visited and we were told that they expressed their satisfaction with the choice of placement. The service users needs had been assessed by the placing authority and Choice Support prior to the placement being made. We saw a contract on the service users file which describes her rights and responsibilities. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this 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 suitable care planning system which takes account of the service users needs and involves consultation with people important to her. Assessments ensure that activities, which may present risks to the service user or others, are addressed properly to keep everyone safe. Staff know that they must keep personal information confidential. Evidence: We were informed by the documents supplied to us prior to the inspection that the home has implemented service user planning systems. Although we were not able to view the service users support plan (as it was being retyped at the local Choice Support office) we saw a range of documents on file and discussed aspects of the service users care with staff. We were told that the support plan is drawn up using photographs and symbols. There is a key work system in place to ensure that the service users care is co-ordinated. We saw notes of key worker meetings which referred to identified goals and progress towards achieving them. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: We heard in discussion and saw evidence of the staff understanding the service users communication methods which assists them to take her views into account. In addition there is a close relationship with the service users family and consultation takes place. The service has contact with an independent advocacy service. Choice Support, the managing organisation has links with a service called Surprise (previously known as Customer Watch), which is a forum through which people with learning disabilities can express their views on the services provided through Choice Support (Southwark). This ensures that the opinions of service users generally are included in the overall planning of the organisation. We saw several risk assessments which enable the service user to take part in activities which require management to ensure her safety. They were appropriate for her needs. Personal information is stored with due regard for confidentiality. Choice Support is registered under the Data Protection Act and there is a confidentiality policy to ensure that staff handle personal information with care. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this 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 service user is assisted to follow suitable activities, but sometimes her opportunties to do so are limited by the availability of transport. Family members are supported to maintain her relationships with people important to her. The meals are varied and reflect the service users nutritional and cultural needs. Evidence: The service user is supported to follow a range of activities, including attending social clubs, swimming and going to a sensory room. We asked about the service users spiritual needs, and were told that consideration is being given to exploring whether she might like to attend a local church. The extent of the service users disabilities means that public transport cannot easily be used. We heard that there have been occasions when community based activities have had to be cancelled because of the lack of availability of transport. The information on the AQAA identifies the recruitment of more drivers as a way that the Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: home could improve in this area of care. The service user is supported to keep in touch with family members. The daily routines are flexible and account is taken of the service users health, mood and preferences. The menu is devised to take account of the service users nutritional needs, preferences and cultural background. Dishes which appeared on the menu included joloff rice and chicken with rice and peas. The service user is accompanied to eat meals out about once a week. We noticed that changes to the planned menu are recorded so that assessment of the service users diet can be made. We judged that she is given a good range of food which includes fresh items. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 staff have suitable information to provide consistent care for the service user. The service user benefits from the careful attention paid to her health care needs. Medication is well managed in the home. Evidence: The staff have access to a range of guidelines which allow them to work towards providing consistent care in keeping with her particular needs. There has been contact with a range of professionals who specialise in the care of people with multiple disabilities. These include, in addition to the GP, speech and language therapists, psychologists, and neurologist. The medication is well managed. The records of administration were good and were complete. The file included instructions on the circumstances in which medication given on an as needed basis might be required. One item of medication requires staff to have specialist training and we were assured that this training has been given. We saw a record of a visit to the home by a PCT Pharmacist in August 2008. The purpose of the visit was to assess the homes management of medication, the conclusion the pharmacist reached was - very well documented and organised, file very good. Care Homes for Adults (18-65 years) Page 15 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 complaints and safeguarding procedures contribute to the protection of service users. Evidence: There have been no complaints made about the services offered at the home over the last year. The complaints procedure is included in the service user guide and includes the required information. The Annual Report issued by Choice Support includes information that the organisation has conducted a thorough review of their policies, procedures and training to ensure that they are aimed at the protection of people who use their range of services. Choice Support introduced a new safeguarding adults policy and procedure in March 2007. The judgement of the CSCI is that this is a thorough document, which is clearly written, and links all the aspects of safeguarding. The policy also introduces an internal protection committee. It is judged that this demonstrates that Choice Support is actively working to improve processes and practice. There are safe arrangements for keeping service users valuables, including checking balances of cash at each shift change and management checks . While we were at the home a member of staff from the organisations area office came to audit the financial records. She said that she found no issues of concern. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: When recruitment records were inspected we found that they contribute to the protection of people who use Choice Support services as they are thorough and meet the legal requirements. Staff are given a handbook, which includes a summary of the safeguarding policy and the whistle blowing policy. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 comfortable, clean and homely and suits the service users needs. Evidence: The premises are suitable for the needs of the service user. The home is clean, accessible and well maintained. The building is an accessible bungalow, with a garden to the rear which people who use wheelchairs can go into easily. The home is in a residential area and is indistinguishable from the other properties in the street. The communal lounge, kitchen and dining area are comfortable and homely. The three single bedrooms are adequate in size. The one which is occupied has been made personal to the service user with the addition of ornaments and personal items. A hoist is available to assist the service user in the bathroom. The bath has an aid attached to it which is unnecessary and needs to be removed. A recommendation is made about this issue. In one of the unoccupied bedrooms we found four canisters of oxygen. the room was unlocked and we were concerned that this represented a risk to the service user and staff, especially as the door of the room was wedged open. In discussion with staff we found that the oxygen had been supplied for use in emergency situations to help the Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: service user. Since then it has been decided that it is no longer necessary. We left an immediate requirement about this issue. We have now been informed that the oxygen has been removed so the matter has now been addressed. The home was very clean and hygienic when we visited, laundry facilities are suitable. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this 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 are enough well trained staff to meet the service users needs. Evidence: The staff team consists of - a manager, an assistant manager and five care staff, two of whom work solely at night time. There are no vacancies oin the staff team and all of the staff arepermanent and full time employees. Two members of staff are on duty during the day time hours. At night time one member of staff is awake in the home to attend to the service users needs. The staff team is well trained with all members having achieved NVQ level 2 or above. Inspectors visited the head office of Choice Support to examine recruitment files. We examined twelve recruitment files. Staff members from all levels were represented in the selection and they are employed at a variety of registered care homes run by Choice Support in Southwark and Lambeth. The files were in good order and all but one item specified by Regulation was present in the files. All of the files had the required checks and references, including Enhanced CRB checks, two references, full work histories and verification that they are physically and mentally fit for their work. We found that the majority of files did not contain a recent photograph of the employee. We discussed this with a member of the Human Resources team and he has agreed to ensure that this is amended. We were pleased to see that service users Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: have been involved in the recruitment process and see this as an area of good practice. Some members of the staff team completed surveys for us. They said that they are provided with training which is relevant to their role and useful. They said that there are usually enough people to meet the service users needs. We were told that staff receive useful supervision and support and this assists them to do their work well. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements are suitable. There are quality assurance systems in place. Health and safety is generally well managed but will be improved by ensuring that, if dangerous items are being stored, risk assessments are conducted. Evidence: The previously registered manager has left his post at the home. The current post holder was appointed during late 2008. She has given us a commitment, in early April 2009 that her application to be registered under the Care Standards Act is to be submitted very soon. There are a number of ways that Choice Support monitor the quality of the service provided at the home. Managers of other homes within Choice Support carry out monthly visits, we saw reports of the visits in the home. Senior managers within the group conduct audits of the service based on standards set by an organisation called REACH. It is aimed at assessing the service users experience of life in the home. The Directors, Managers and Trustees of Choice Support meet regularly with representatives of service users who sit on a service user forum. They are involved with reviews of policies and procedures and two people with learning disabilities are part of the organisations Quality Assurance sub committee. A national Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: survey by Values into Action had been commissioned by Choice Support to assess the opinions of service users. At a more local level the Registered Manager completes a quarterly report for the residents placing authority. These monitoring systems supplement the internal scrutiny and act as a further safeguard for residents. We saw the file in which checks of health and safety matters are recorded. We were surprised not to find a risk assessment concerning the oxygen, previously referred to in the section about the environment. We have made a requirement about this, to ensure that such assessments are performed if items are stored which may present risks. In all other respects health and safety matters were well managed. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 The Registered Person must make amendments to the statement of purpose to ensure its accuracy. This will enable potential service users to have full and accurate information about the home. 04/05/2009 2 42 23 The Registered Person must 04/05/2009 give a commitment that in the event that items which present risks are being stored assessments must be conducted with the aim of minimising the risks. So that service users, staff and visitors are kept safe. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 13 Efforts should continue to ensure that the service user is Page 25 of 27 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations able to access transport to get to community based activities. 2 29 It is recommended that the bath aid, which is not required by the service user, is removed. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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