Care Home: Dove, The

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Dove, The 36, South Croxted Road London SE21 8BB two star good 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: Mary Magee Date: 1 3 1 0 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 – 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: Dove, The 36, South Croxted Road London SE21 8BB 02087614143 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): the_dove36@yahoo.co.uk L`Arche Lambeth Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home Only (CRH - 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: 3 Date of last inspection Brief Description The Dove is a large semi detached Edwardian house located on a residential road in West Dulwich. It provides care and accommodation for up to three service users with learning disabilities and two members of staff. The Dove is one of five homes owned by LArche Lambeth, part of the national organisation, whose communities are based round small scale, everyday housing within local neighbourhoods. The home is on a bus route and close to local shops, restaurants and a large park. In October 2006 there were three residents. Potential residents are given information about The Dove using the home?s accessible service users? guide (called an Easy Read guide). The document describes the house, the people who live there and the opportunities available. People interested in coming to live in the Dove would be invited to visit, initially for tea or a meal and then for longer periods as their interest develops. Any carer, supporter or Care Manager would also be welcome to visit. A `moving in? manager is responsible for the process of welcoming someone to the L?Arche community and is available to answer questions from the potential member and their supporters. The post holder is skilled in accessible communication, including the use of Signalong and Makaton. The statement of purpose is also available, although this is not accessible. Copies of the most recent CSCI reports are offered to anyone interested in coming to the Dove. Although the reports are not yet accessible, members of the L?Arche community would talk someone through the main issues and answer any questions. The current weekly charges are from #902 to #950 (including a place in L?Arche Day provision). Additional charges would be made for individual (1:1) support needs. L?Arche funds an annual holiday but if a member chose to take an additional holiday the costs would be charged separately. No other additional charges are made. 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 How we did our inspection: We visited the service over two days, visits were unannounced. We met with the manager, and three support workers. We spent some time with a more recently admitted resident and observed the support he receives. We received comments directly by telephone from a care manager involved in the placement of a resident. We examined a number of records in relation to the admission and progress of residents, also staff personnel files that include recruitment. We received a completed AQUA that gave us information on the service. We used the information received at CSCI in relation to the service history, events and notifiable incidents. Surveys were returned from residents earlier on in the year. What the care home does well What has got better from the last inspection: One resident has moved on from the Dove into her own independent accommodation. She made excellent progress when living at the home and developed the skills necessary to live in her own house. Support staff assisted with the transition and continue to enable the person to retain links with the residents. Fire drills are carried out with more frequency. Medication procedures have improved with all records clearly documenting the medication administered. Repairs are attended to satisfactorily and this includes issue raised in the last inspection. What the care home could do better: The home is generally well maintained. There are a few areas of the lounge that need attention, in the archway from the constant use of wheelchairs the decor has become a little distressed, the carpet too needs heavy duty cleaning. A requirement is stated. A senior member of staff needs to visit the service every month and complete a report on the findings. This will assist the manager in the running of the home. A number of recommendations are made in relation to the newly appointed manager. he is familiar with residents needs, has the potential to do a good job. He should receive training and development to assist him in his role. He should complete the CSCI application form to register as the manager. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . For prospective residents individual needs and aspirations are assessed and considered fully before offering a placement. The home makes available all the necessary information on the services provided. People moving to the home are assured that their needs are met by a skilled staff team that are dedicated to caring and supporting people that are disadvantaged by learning difficulties.. Evidence: Good information guide in easy read format, it gives an indication of life at the home. People can test drive the home and sample life before moving there permanently. The Preparations for admission are good. All the necessary information and support networks including care managers and health professionals are involved. The home is good at completing needs assessments and finding out as much information as possible before offering a placement. Staff employed have a keen interest in supporting people that are disadvantaged by learning difficulties. They acquire a good understanding of individual needs. They become familiar with the communication methods for each individual and use these effectively. 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 . Care planning and support arrangements are good. Records are made of individual support needs. Consideration is given to identifying and responding to any risks. Measures are in place to manage these without limiting or restricting the lifestyle of residents too much. The home promotes an inclusive environment with residents encouraged to influence the service. Residents receive the necessary support they require to manage their finances safely. Evidence: We observed written care and support plans developed and agreed with residents. The detail is good with confirmation that these are reviewed every six months. Risks associated with individual conditions are identied. Measures are in place to manage these appropriately. People using the service are invitedto share their views. Weekly meetings are held to enable this. We find that the service has effective systems in place to support residents manage their finances safely. Procedures are in place to monitor these financial systems on a regular basis. 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 quality of life experienced by people living at the home is good. The small domestic scale environment promotes an inclusive feel. Residents and staff enjoy sharing meals of their choice. Individuals have the opportunities to develop social and independent living skills and link into other resources in the community organised by LArche and other providers. Evidence: The home makes provision for each person living at the home to access actvities and leisure activities. Independent living skills are are encouraged through tasks an rotas in housekeeping, cooking, budgeting. In the past twelve months all those living at the home enjoyed a holiday at another LArche centre. Residents take responsibility for tasks in the community when performing tasks at the workshops. A small wage is given in return for work and commitment. Two of the residents attend daily workshops where they assist and learn homecrafts in candlemaking, weaving and stonework. The organisation is Christian based and careful consideration is given to residents spiritual needs. All are supported to attend church services in the community of their choice. Visitors are invited to share supper at the home. Strong friendships have been formed with residents from other homes and regular invites are received by residents to attend suppers and functions at the other L Arche homes. Contact with family and friends is supported and promoted via telephone and receiving visits. For a newly admitted resident his circle of friends are involved in his care planning and maintain contact with him. Staffing rotas are reflective of individual needs. For example the majority attend workshops daily. One resident is unable to Evidence: attend, he has daily one to one support to support him with his hobbies of music making, also exercise plan. Residents are offered choice in relation to menus. Weekly residents meetings take place. During this time menus are chosen. Support workers share the main evening meals with residents. This gives a unique family feel to mealtimes. We observed meals on both visits. One resident was present. To accomodate his dietary need and swallowing concerns as recorded in care plan the food was prepared and mashed to correct consistency. A member of staff was present to supervise and support the resident during this time. 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 quality of life experienced by people living at the home is good. The small domestic scale environment promotes an inclusive feel. Residents and staff enjoy sharing meals of their choice. Individuals have the opportunities to develop social and independent living skills. Residents have a strong presence in the community and access resources organised by LArche and other providers. Evidence: Contact with family and friends is supported and promoted via telephone, using e mails and receiving visits. For a newly admitted resident his circle of friends are involved in his care planning and maintain contact with him. Staffing rotas are reflective of individual needs. For example the majority attend workshops daily. One resident is unable to attend, he has daily one to one support to support him with his hobbies of music making, also exercise plan. Residents are offered choice in relation to menus. Weekly residents meetings take place. During this time menus are chosen. Support workers share the main evening meals with residents. This gives a unique family feel to mealtimes. We observed meals on both visits. One resident was present. To accomodate his dietary need and swallowing concerns as recorded in care plan the food was prepared and mashed to correct consistency. A member of staff was present to supervise and support the resident during this time. We looked at medication procedures. All the MAR sheets had signatures present to acknowledge that prescibed medication was administered. Medication was stored safely, blister packs are used by the dispensing pharmacist. A regular audit of medication stock has begun recently. This should be undertaken regularly. Support workers support residents with healthcare appointments and to attend them. Professional input is sought from ALD team, OT, Physiotherapist, speech and language. Support workers are involved and attend a the regular CPA meetings held with a resident.The home has not used the health action plans as yet for recording with residents the health care support. 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 service provides an open and inclusive environment, residents find that their views are lsitened to and and acted on. Safeguarding procedures in place are robust and mean that residents are protected from abuse or neglect. Evidence: An accessible picture format of the complaints procedure is displayed prominently on the noticeboard. The complaints procedure is discussed at residents meetings so that there is a good awareness on how to make a complaint and the relevant people to refer to. A complaints book is held of all issues raised , the acknowledgement and the response time with timescales involved. CSCI has not received any complaints about the service. Copies of any complaints are held on the relevant residents file. We found that there are few complains and that these are responded to satisfactorily. We were in discussion with three staff members. Staff are knowledgeable on procedures that safeguard vulnerable adults.The home has not received any allegations that require investigations under safeguarding procedures. 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 . This home provides an attractive, safe and homely environment. Comfortable shared space compliments the pleasant individual bedrooms. Residents are provided with all the necessary equipment and adaptions. Evidence: The home is small and homely. Shared lounges/dining area and individual bedrooms are spacious. The home benefits from the provision of a conservatory that is used as an additional lounge. The location is good, close to public transport and to other LArche homes for socialising. The ground floor is accessible to wheelchair users. Bedroom doors have locks that can be overriden in case of emergency. People living in the home are provided with all the necessary equipment and aids that promote and monitor conditions. Furnishings and fittings are provided that compliment the home. Appropriately placed bathroom and toilets are located at convenient positions. The home is clean and odour free. Temperatures of fridges and freezers are monitored for effective working. Some areas show signs of wear. The lounge carpet is stained and needs heavy duty cleaning, also attention is need to the decor in the archway to the lounge. 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 home operates thorough recruitment procedures that safeguard residents. The needs of residents are met by caring staff that are appropriately trained. Staff receive effective support and supervision to enable them carry out their roles in the appropriate manner. Evidence: Many overseas support workers are engaged, the home overcomes the obstcales and manages to train and develop staff and equip them for the roles. The majority see the role as a vocation and are commited to the Christian ethos of caring for people. Recruitment procedures are good and staff are fully vetted before they are engaged. The organisation provides a comprehensive induction training and foundation programme that equips staff for the job. A training needs assessment is completed following induction, the home responds well to the training needs of staff. Ongoing training and development is provided to enable staff members have a good understanding of the needs and behaviours of residents. WE met with three members of staff. They demonstrated good people skills and show genuine interest in the role of support worker. According to records seen regular team meetings and supervisions are held. The organisaion states in the AQQA that it is in the process of recruiting additional local based staff. 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 smooth running of the home has not been disrupted during the management change over period. As the new manager is familiar to residents and staff a warm homely environment continues to be experienced in this house. House assistants organise their times to meet the needs and desires of residents. The organisation has effective systems in place to promote the health and safety of residents and staff. Quality assurance places residents at the heart of the service. Evidence: A change of manager has taken place. Despite this the home is well run, continuity is maintained in the service. The newly appointed manager is familiar with the organisation having worked in this and other homes for nearly two years. He is experienced in supporting the resident group and has a good knowledge of the needs of the resident group. He should acquire more knowledge and skills to equip him for the managers role. He has planned to complete NVQ Level 4 between 2008/2009. Registration with CSCI should take place. The house and its equipment are serviced and maintained in good order. Regular health and safety checks take place. Fire drills and fire alarm checks are undertaken with the frequency required in the fire risk assessment. Hot water temperatures are maintained within safe limits. We were unable to view Regulation 26 visit reports, there was no records of these visits held at the home. Staff were unclear if the visits were done recently. Itis important that management support is given especially As a recent house manager change took place. Policies and procedures are in place that refelct current legislation, it was observed that some should be updated. The service is monitoring the quality of the service, regular reviews take place of the outcomes for residents. The community undergoes an annual review where residents meet with a senior manager from LArche UK. Following this review a report is prepared on communitys overall wellbeing, it also Evidence: identifies priorities for the following year. Each resident attends a talking group witht he director, minutes are minuted.The organisation has a forum wherby residents are 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 1 28 23 Internally the lounge archway needs to be redecorated, carpet needs cleaning 19/12/2008 So that the home provides aclean comfortable environment 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 39 26 Visits in accordance with Regulation 26 must be undertaken by a senior manager from the organisation and be unannounced 31/10/2008 To interview residents and staff and to oversee the management of the home 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 19 More consistency is recommended in the formats used for recording daily and monthly progress and events. Health action plans should be used for each resident Regular audits of medication stocks should be undertaken The registered manager should continue with his professional development to acquire the knowledge and skills required for the role of manager. The manager should ensure that a completed managers application is submitted to register with CSCI 2 3 20 37 4 37 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). 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