Care Home: Deepdene

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What the care home does well Medication training occurs annually and additional annual training occurs in as and when medication, and also in rectal diazepam usage. A new, more accessible pictorial household chores rota has been drawn up giving clearer, more accessible information to service users. The manager has initiated training in the National Minimum Standards and how these standards can benefit service users. The Trust dietician visits the home on a regular basis to check the menus for nutritional value. What has improved since the last inspection? The Controle Of Substances Hazordous to Health products locked at all times. Portable appliance testing had now been carried out. The gas safety certificate was now available. What the care home could do better: Two references are needed for all staff to better protect residents. A letter from an employer stating references are not provided by them does not count as one of the required references. This is needed to ensure undesirable staff are not employed. Although there has been some improvement in supervision frequency, staff still do not receive supervision at a rate of at least 6 sessions per year. This is needed to ensure a well supervised workforce. One of the toilets sinks had a broken tap. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Deepdene 1 Deepdene Avenue East Croydon Surrey CR0 5JP     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: Barry Khabbazi     Date: 0 4 0 5 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 22 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 22 Information about the care home Name of care home: Address: Deepdene 1 Deepdene Avenue East Croydon Surrey CR0 5JP 02086679753 02086803406 jacqueline.alby@surreyoaklands.nhs.uk 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) : Surrey and Borders Partnership NHS Trust care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 8 Deepdene is a residential unit registered to provide care to eight people with Learning Disabilities between the ages of eighteen and sixty-five. All the service users have been assessed as having high dependency needs. The premises is a detached two storey house in a residential road in East Croydon close to Lloyd Park, tram links and within easy walking distance of Croydon town centre. It has eight single rooms, two of which have en-suite facilities, a dining room, lounge, sensory room, kitchen, laundry, and several bathrooms. There is also a large secluded garden to the rear of the building with a patio area and a summerhouse. Fees currently range from #1388/week. This is about to be updated for 2008/9. Care Homes for Adults (18-65 years) Page 4 of 22 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: The quality rating of the service is 2 star. This means the people who use this service experience Good outcomes The key Standards identified throughout this report were assessed at this inspection. This inspection was unannounced and started early in the day to allow the residents to be met, before they went to their day activities. During this inspection the residents and staff were met and the manager was interviewed. Records, policies, care plans and the building were examined. Care Homes for Adults (18-65 years) Page 5 of 22 Care Homes for Adults (18-65 years) Page 6 of 22 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. Cupboard is now kept Care Homes for Adults (18-65 years) Page 7 of 22 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 22 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Evidence: People who want to live at this home can be confident that their needs and aspirations will be assessed and recorded so that they can be met by the home. Care Homes for Adults (18-65 years) Page 9 of 22 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. Standards, 6, 7, and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Evidence: The needs and changing needs of people who use this service are assessed and recorded so that staff know and can therefore meet these needs. However, the information is recorded over a number of documents and could be difficult for new staff to find. People who use this service are supported to make decisions about their lives, to maximise their independence and choices. Risk assessments contain all the information required as including this information Care Homes for Adults (18-65 years) Page 10 of 22 Evidence: could reduce the risk for people who use this service and remove unnecessary restrictions of liberty. Care Homes for Adults (18-65 years) Page 11 of 22 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. Standard, 12, 13, 14, 15, 16, and 17. Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Evidence: People who use this service receive sufficient access to activities to maintain a stimulating life. People who use this service are regularly participating in the local community, with the aim of maximum integration and challenging discrimination. People who use this service are supported in maintaining appropriate relationships, so Care Homes for Adults (18-65 years) Page 12 of 22 Evidence: that their social lives are maximised within chosen boundaries. The daily routines and house rules do generally promote the rights of people who use this service, to ensure equality and that all rights are enjoyed by all. Dietary needs are catered for and a balanced diet is provided, to ensure good health and enjoyment of food. Care Homes for Adults (18-65 years) Page 13 of 22 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. 18, 19, and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Evidence: Personal care is now carried out in a way that people prefer so that dignity and choice are maintained. The physical health needs of people are met by this home. This ensures that the physical health is well maintained and therefore the quality of life experienced is also maximised. Medication is well managed and staff have had approved and accredited medication administration training to promote safer medication administration. Care Homes for Adults (18-65 years) Page 14 of 22 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. standards 22 and 23: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Evidence: Complaints are well so that people feel their concerns are listened to, and the complaints procedure is now more accessible. The protection policies and procedures promote protecting people from abuse. Care Homes for Adults (18-65 years) Page 15 of 22 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. 24, 27 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Evidence: The building, rooms and furniture generally meet peoples needs and provide a comfortable environment that promotes independence. Toilets and bathrooms provide sufficient privacy to meet people needs. The home is generally hygienic and clean, homely and comfortable. This environment therefore facilitates peoples health and emotional well being Care Homes for Adults (18-65 years) Page 16 of 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 32, 34, 35, and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Evidence: People who use this service are supported by appropriately qualified staff, which raises the quality of staff and their practices. The home has exceeded the 50 of staff who are required to have an NVQ2 qualification. This provides a well-qualified staff group. The homes recruitment procedures have protected the people who use this service through vigorous staff vetting in the past. However more diligence is required to ensure that all references fully meet the standard required. Staff supervision is occurring but not all staff receive all the supervision they need to be properly managed. Care Homes for Adults (18-65 years) Page 17 of 22 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. Standards 37, 39, and 42: Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Evidence: The home is managed by an experienced and well-qualified new manager who can ensure a quality service. There is a quality assurance system, which involves the people who use this service and provides a way for them to measure improvements in quality for themselves. The home generally promotes the health and safety of the people who use this service, so that practices and the environment do not generally place their health and safety at risk. Care Homes for Adults (18-65 years) Page 18 of 22 Care Homes for Adults (18-65 years) Page 19 of 22 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 20 of 22 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 34 17 Two references are needed for all staff. 18/07/2009 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 36 Staff must receive supervision at a rate of at least 6 sessions per year. Care Homes for Adults (18-65 years) Page 21 of 22 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. 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