Care Home: Conan Doyle House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Conan Doyle House 12 Tennison Road South Norwood London SE25 5RT three star excellent service The quality rating for this care home is: 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: James Pitts Date: 0 4 1 2 2 0 0 8 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. They reflect the things that people have said are important to them: 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Conan Doyle House 12 Tennison Road South Norwood London SE25 5RT 02087681630 02087681539 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Care Support Service Ltd trading as `Pathways` care home 9 Number of places (if applicable): Under 65 Over 65 9 0 learning disability Additional conditions: 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 9 Date of last inspection A bit about the care home Conan Doyle House is registered to provide care and accommodation for nine young adults who have learning disabilities and is operated by Caretech. The home is located in South Norwood and is well positioned to access a range of community amenities and transport links. The home provides a specialised service that currently caters for the needs of eight young adults who display behaviours that may challenge the care services that they require. The home supports people with autism. It is a large house on a three-floor storey with en suite single rooms provided for the service users. There are spacious communal areas that include a lounge, two dining rooms and a sensory room for relaxation. The rear garden is well maintained and has a patio, large lawn area and orchard/ vegetable patch at the end. Conan Doyle s mission statement says Our mission is to make a difference in peoples lives through learning, positive experiences and personal growth. 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: three star excellent 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 How we did our inspection: This is what the inspector did when they were at the care home This inspection involved two separate visits to the service, conversations with people who live and work at the home and examination of care planning and other records that are held on site. We also received 5 questionnaires from people who use the service prior to the inspection visits. These show that people know what to do, and who to speak with, if they have any concerns. They also feel that they usually, or always, receive a good service and that the staff treat everyone well. What the care home does well What has got better from the last inspection The building work that has been commented upon previously is now being addressed. The refurbishment should do much to ensure that the environment once again achieves the necessary standard and in fact should result in a very comfortable home for the people who live here. Staff appraisal and training is much improved and this too is having a positive outcome on the quality of the service that is provided. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact James Pitts Caledonia House 223 Pentonville Road London N1 9NG 020 7239 0330 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use this service can continue to feel confident that if anyone new moves in that the home will ensure that they can provide a service and that everyones wishes and feelings about newly referred users of the service are given the proper consideration. Evidence: The home has not admitted anyone new for quite some time, and one person moved to another service earlier this year. One of the other people is due to leave soon to move to a service where they will be more independent. Someone is currently going through an introduction to the service prior to moving in next month. The person in question made very positive comments about how they were getting to know the people who they will be living and the staff who will be working with them. This person is clearly looking forward to coming to live permanently at the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use this service can feel fully confident that their unique needs are recognised and that they will be provided with the right support to enable each person to live as independent a life as possible. Evidence: Examination of the care plans for the three people who are remaining in permanent residence showed that all have had a review of their care and support needs, including updates of any risk assessments, in the last six months. All care planning and risk assessment documentation is well presented and reflects the individual needs for each person. Care plans continue to be created in a way that is the most accessible for each person rather than merely using a standardised format for convenience. This shows that a significant amount of time and effort is given to ensuring that the people who use this service are respected as separate and unique people. Communication and choice are seen as very important and a lot of emphasis is placed on maximising the involvement and of seeking the views of the people who use this service. The home works extensively with people who have needs that fall within the autistic spectrum disorder category, and to this end the staff team of the home are in the final stages of completing the accreditation with the National Autistic Society. This has necessitated a lot of hard and committed work to show that there is truly a depth of understanding by the staff team of the specialised needs of the people who the support. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use this service can feel confident that they will get the right support to achieve and maintain their chosen lifestyle in a way that recognises and respects their unique and individual personality. Evidence: The people who use this service are supported to make use of a wide range of community based facilities and activities. These can vary from attendance at day care services at specific times each week, college courses, leisure activities and hobbies and interests that are of personal preference. It is evident that this is done within a framework which allows each person to explore a lifestyle of choice but also to experience new things that may enhance peoples life experience. Contact with family and friends is also actively encouraged and supported by the staff team. It is clear from the interactions that were observed that each person who uses this service is acknowledged as an individual and respected by those who provide support at the home. The unique heritage, both cultural and religious, is given the necessary degree of importance. During the second day of this inspection the relative of someone who lives here was visiting and discussed ways in which to increase the interaction and involvement of their loved one in the lifestyle of their particular cultural and religious community. The people who live here are also involved in menu planning and meal preparation as far as possible, as well as the usual household activities that take place and are a Evidence: shared responsibility. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use this service can feel confident that they will continue to receive the right support to maintain good health but also the right response from the staff if there are any times that they become unwell. Evidence: The people who use this service all have extensive health and personal care planning records. It is evident that consultation occurs in order to maximise the ability of the service to adhere to peoples unique preferences as far as is practicable and safe to do so. The staff team, each persons own key worker in particular, are currently updating health action plans to bring these into the system that is used by Caretech as the registered provider. All of the people who use this service are registered with local GP practises and records show that health care needs are quickly attended to as and when these arise. Medication is well kept and is managed properly. Staff are trained about safe keeping and handling of medicines and are assessed as competent before being allowed to administer medicines. None of the people who use this service are able to independently manage their own medicines and the reasons for this are properly documented and agreed. There are also comprehensive procedures in place that everyone is expected to comply with. Medication is kept in the form of a monitored dosage system that is resupplied every month by a local pharmacy, who also provide periodic audits and advice on procedures and practises. It is positive to note that where PRN (as required) medication is prescribed that this is not overly used and their are very clear guidelines in place as to what should be done prior to any additional medicines being given. 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 people who use this service can feel confident that the staff team of the home now what to do if there are any complaints or concerns about abuse. They also do all that they reasonably can to keep people safe. Evidence: The home has complaints information which exists in both a picture and word format to maximise the potential for understanding of the people who use this service. The registered provider also has policy and procedures in place for staff to follow should a complaint be made. There has been one complaint made to the home in the last year, this was minor in nature and was properly resolved. No formal complaints have been made to the Commission since the previous inspection of this home. There is also a great deal of information available about what the home should do if there are any concerns of harm or abuse raised. The staff team have access to the organisational policy and procedure as well as the local geographical authority procedure, being the statutory agency that the home would always have to report any concerns to. Approximately half of the staff team have had updated training since March of this year about protecting vulnerable adults from abuse. Two concerns that may have been potentially safeguarding issues were raised in the last year although neither of these resulted in any finding that anything untoward had occurred. 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 people who use this service can feel increasingly confident that the home in which they live is on the way to being a pleasant and comfortable environment for them to live in. Evidence: Over the inspections that have taken place in the last 18 months or so the Commission has repeatedly noted that there was much work to be done to make repairs and refurbish the home. Caretech as the registered provider had taken a significant amount of time to address these issues although at last it can be said that major repair and refurbishment work is now underway. At the first day of this inspection a discussion was held with the building work project manager who explained that in excess of one hundred thousand pounds is being spent to replace a number of Windows, make repairs, redecorate and refurbish the bedrooms, lounge and bathrooms as well as replace all of the flooring and much of the furniture. This work has recently started and improvements are already noticeable. It is positive to note that the way in which this major work is being organised is considerate of the people who use the service and focusing on minimising disruption to them. Given that there is so much work underway the home is, none the less, kept as clean as it can be under these circumstances. 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 . The people who use this service can feel confident that the staff are increasingly well trained and supported in the work that they do and that this is having a positive outcome in the quality of the care and support that is provided. Evidence: All of the staff team are working toward either NVQ level 2 or level 3 although one person already has the NVQ level 2 qualification. This training is included in each persons annual appraisal and development plan, 4 of which were seen and show that this system is operating correctly. Examples of staff training, aside from the NVQ training, that has happened over the last year include, fire safety, risk assessments, moving and handling, protection of vulnerable adults, food hygiene, and empowerment of people who use the service. The appraisal and development plans have much improved since the previous inspection of this service. The home has not employed any new staff since the previous inspection although one member of staff transferred to work here from another home that is owned and managed by Caretech. Historically this service has been seen to recruit staff properly, including good interview and take up of references, necessary background checks and verification of employment history. This area will of course be examined again at such time as any brand new staff are recruited. The record of individual staff supervision is showing that the service is on target to achieve the minimum of six supervision sessions per member of care staff per year. The supervision responsibility is shared between the manager and deputy manager and the usual rule of thumb is that supervision should take place monthly. Obviously this may not occur exactly to that schedule for a variety of reasons but it is an effective way of at least being able to provide the minimum frequency of supervision in each year, and in some cases possibly exceed that target. 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 . The people who use this service can feel confident that they are living in a home that is well managed and usually a safe environment for them. Evidence: The manager of the home was registered with the Commission earlier this year and has the necessary background and experience to manage a care service of this kind. He is also presently undertaking NVQ level 4 in management of care services. It is evident from feedback that was received prior to this inspection, during the visit and in discussion with some of the people who use or work at this service that an open and transparent management style exists. The people who live here are placed at the forefront of consideration when decisions are being made about how the service operates. Monthly visits by a representative of Caretech, the registered provider, are also occurring and these show that oversight about the day to day operation of the home is happening as it should. In the most part the people who use this service are protected from unnecessary hazards to their physical safety. All of the necessary annual safety checks occur, with the exception that the Portable Appliance Test is now overdue as this was last done in Sept 2007. All other safety records show that the home is a safe place to live and work. Weekly fire alarm bell tests and quarterly fire drills are happening and the fire drill record also includes data about the time the drill occurred, the time taken to evacuate the building and the people who were present when the drill took place. The previous inspection identified that a fire door on the upper first floor was regularly being broken, a permanent solution to this problem is being implemented as was previously required. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 41 23 The portable appliance test must be undertaken as this is now overdue 30/01/2009 Electrical equipment safety may be compromised and place those who live or work at the service at risk. 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 Helpline: 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 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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