Care Home: Foxley Lane

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• Foxley Lane (121a)

What the care home does well It is clearly evident that a significant amount of planning and careful consideration has gone into the design of the facilities and the establishment of a service that is able to meet the stated aims and objectives. Any new service would understandably go through a teething period and require time to become properly established. However, it is highly positive to note that this service has not encountered any notable teething problems. This demonstrates the effectiveness with which the service was planned and designed before it began actual operation. What has improved since the last inspection? As this is the first inspection since registration there were no previous areas of improvement required. What the care home could do better: It is commendable that no issues have arisen, either through requirements or recommendations, as a result of this first inspection. The service is congratulated for that and the Commission is confident from current evidence that the service hasthe ability to maintain and even improve upon the positive outcomes that it currently provides for the people who live at Foxley Lane. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Foxley Lane 37 Foxley Lane Purley Surrey CR8 3HR 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: James Pitts Date: 2 9 0 1 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. 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 Inspection report CSCI Page 2 of 28 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Foxley Lane 37 Foxley Lane Purley Surrey CR8 3HR 02086608928 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Independence Homes Limited Name of registered manager (if applicable) Suzanne Louise Curtis Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: The Registered Person may provide the following categories 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: 8 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 28 A bit about the care home Care Homes for Adults (18-65 years) Page 5 of 28 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 Care Homes for Adults (18-65 years) Page 6 of 28 How we did our inspection: This is what the inspector did when they were at the care home This visit took place during the daytime and there were two people who use the service present, the manager and a senior manager from Independence Homes and various members of the staff team. The people who live at the home are not able to express their views through the use of questionnaires although relatives can do. The Commission will take any views that may be subsequently expressed into consideration at such time as any may be received. Standard required records were examined which included care plans, staff recruitment and policy documentation. The Commission, as a part of this inspection, also took into consideration the annual quality assurance assessment that was completed by the registered manager and other information that has been received since the service was first registered in July 2008. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well What has got better from the last inspection What the care home could do better It is commendable that no issues have arisen, either through requirements or recommendations, as a result of this first inspection. The service is congratulated for that and the Commission is confident from current evidence that the service has Care Homes for Adults (18-65 years) Page 8 of 28 the ability to maintain and even improve upon the positive outcomes that it currently provides for the people who live at Foxley Lane. 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 33 Greycoat Street London SW1P 2QF 02079792000 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 Care Homes for Adults (18-65 years) Page 9 of 28 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 10 of 28 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 . The people who use this service and others are told what the home does and how it will do it. The service effectively and sensitively manages the referral and admission process, taking into account the unique needs of each person and their families. Evidence: The statement of purpose for the service is detailed and properly outlines what the home provides and how the people that use it will be supported. In discussion with the manager of the home and a senior manager from Independence Homes it was recognised that the people who use this service would not find either a written or pictoral format accessible. However, it should be recognised that as the communication methods of each person are better known that the service is committed to keeping the statement of purpose and service user guide under review. This is not least in terms of identifying the most meaningful ways in which this information may in future be presented to those who use the service. Since the home was originally registered in July 2008 three people have been admitted. Full and comprehensive assessments were carried out prior to their admission and these show that the service is able to meet their needs. These Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: assessments involved the manager and other specialist professionals that are employed by the registered provider. The service demonstrates a commitment to ensuring that the transition of people who are referred to the service is managed sensitively and takes into account that this can be an anxious time for both them and their families. Each person who uses the service is provided with a contract that outlines what the service will do and the agreed level of support that each person requires. Care Homes for Adults (18-65 years) Page 12 of 28 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 . The people who use this service can feel confident that their care and support needs have been properly assessed. As a result of this there are care plans in place that ensure that those who work with them are aware of their unique and individual requirements. Evidence: Each of the people who use this service has an allocated keyworker and a co keyworker. These people have a focus of ensuring individual needs are met. The care plans are detailed and are understandably still a work in progress as more becomes known about the unique personality and day to day needs of each of the people who live here. It is positive to note that specialist input is also considered an important part of care planning and it is not just seen as an isolated practise for the staff team who work directly with the people at the service. The team demonstrate a commitment to making sure that all the people who live here are allowed to make choices about how to live their life. This is aimed at encouraging people to make knowing and informed choices rather than playing mere lip service to Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: rights of consultation. As mentioned earlier in this report the people who currently use this service have limited verbal or written communication. This has lead to the service, as they become increasingly aware of the extent and methods to which each person does communicate. undertaking to keep these opportunities for involvement constantly under review. The home writes a risk assessment for each of the people who use this service. A risk assessment tells the staff how to make sure that each of the people living at Foxley Lane is kept safe from anything that might harm them. The initial pre placement risk assessments were completed as required and the organisational policy ensures that procedures are in place to review these at regular intervals and more frequently should the need arise. Independence Homes has detailed policy and procedure information for staff about maintaining the confidentiality of those who use this service. These include the safeguard of only sharing information with those who have a right to know. Care Homes for Adults (18-65 years) Page 14 of 28 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 people who use this service can feel confident that the staff of the home will provide active support for each person to participate in the community both in terms of the activities of daily life and leisure interests. The opportunity for each to maintain personal and family relations is encouraged and is actively supported by the staff team. Evidence: It is a demonstrated aim of the service to ensure that each of the people who live here is supported by the staff to be as independent as possible and to make as many choices as they knowingly can. All who live here are in the process of developing a varied programme of activities. These include therapies that are geared to maintaining each persons wellbeing as well as social and leisure interests. As referred to earlier in this report, as more knowledge of the preferences of those who live here becomes known this will allow for even further finite tailoring of leisure and activity plans. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: There is a driver employed by the company to ensure that when a driver for the vehicles that the home has is needed there is someone available. The staff team encourage the people who live here to keep in contact with their families. Family members are made very welcome when they visit the home and an open visitors policy, where reasonable, exists. The menu reflects individual likes and dislikes, with input from a nutritionist, with a choice of two meals provided. If both are refused alternatives will be explored and offered. The people who use the service can choose when and where they wish to eat their meals. Care Homes for Adults (18-65 years) Page 16 of 28 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 people who use this service can feel confident that they will get the right support to take care of their personal and health care needs and that the necessary facilities exist to enable this to happen safely. Anyone who needs to take medicine regularly to help them stay well will get the proper support from staff to make sure that this happens. Evidence: The home has a specially designed bespoke seizure monitoring alarm system in place and a call button. This has been designed to incorporate all types of seizure activity. This alarm system also has the facility to snooze to allow privacy. All service users receive input from a vairiet of specialist care professionals and therapists. Each person who uses this service have detailed person centred care plans that highlight their personal support requirements and preferences. The home has an Epilepsy Nurse Specialist on call twenty four hours a day whose role it is to respond immediately if there are any concerns about the general well being of Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: any service user. All service users have their own GP and Consultant Neurologist. Staff support service users to attend medical appointments. The manager has a monthly meeting with the Epilepsy Nurse Specialist where all service users health and medication is monitored and reviewed. Service users also have access to a homoeopath who visits once a month to review their general well being and current homoeopathic remedies. All staff are trained in medication handling and administration as a standard part of the organisational induction. The procedure then requires that they be observed administering the medication to all service users on two occasions before being approved as competent. Senior staff undertake a Senior Medication Training course. MAR charts are kept in the home that record all medication that is received and is administered. Examination of these documents show that these records are being properly maintained. Each person who uses the service also has their wishes in the event of death recorded in their individual files. These forms were completed with the help of their families when they first moved into Foxley Lane. Care Homes for Adults (18-65 years) Page 18 of 28 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, and their families, can be assured that the staff team of the home know what to do to respond to any complaints or concerns that may arise. Evidence: The people who live here, and others, are given clear information about how to complain and what happens when they make a complaint. Neither the service, or the Commission, have received any complaints sine the home was registered in July 2008. There is also clear written information for staff about what to do if they think that anyone who lives here is being hurt or abused by another person, or if an allegation is made. The procedures and guidance also include those of the local geographical authority which in this case is the London Borough of Croydon. No concerns have been raised with the service, local authority or the Commission since the home was registered. All staff complete training in the protection of vulnerable adults as part of their standard induction when they are first employed and the organisation has procedures in place to ensure that refresher training occurs at regular intervals. Care Homes for Adults (18-65 years) Page 19 of 28 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 confident that they are living in a home that has been well planned, well designed and provides all of the space and facilities that they need. The house is well decorated, maintained and furnishes as well as being kept clean and hygienic. Evidence: The home is a purpose built house and is equipped to meet the needs of the people that the service is designed to accommodate. There is a lift to the first floor, specialist baths and wet rooms, a sensory room, a tracking hoist around the house, a magnetic blackboard wall in the service user dining room. A piano keyboard in the therapy room and Sky television points in every room. The house is also equipped with under floor heating to avoid the danger of anyone having a seizure and falling against a radiator. A maintenance and renewal plan is also in place. The home is bright and clean with all rooms meeting the minimum total average living space. Each service user has a bedroom suitable to their needs and lifestyle. Service users have furniture provided by the organisation, although some choose to have their own. Service users are encouraged to personalise their rooms. Bedrooms are lockable all with a sink and en-suite toilet. All rooms have an alarm call point for the service Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: users or staff to use in an emergency. Everyone who lives here has access to a multi sensory room within the house. The organisation and home has an infection control policy which all staff read as part of their induction. The laundry room is equipped with a commercial washing machine, that has a sluice programme for soiled laundry, and a tumble dryer. The home has a large back garden which is accessible to all service users via a ramp. It also has a sensory garden area and swing which can be adapted to accommodate a wheelchair along with a selection of giant garden games and equipment. The home has a contract with a gardening contractor to maintain this area. The home is large and has more than enough space for day to day living and storage of any mobile specialist equipment that service users may need. In fact there is so much space that in some areas the organisation has yet to decide how to use the space that is not required for use by the people who live here. Care Homes for Adults (18-65 years) Page 21 of 28 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 there is a committed staff team to meet their needs and that these staff are safe people to support them. Evidence: The staffing rota shows that there are sufficient staff on duty for each part of the waking day to ensure that the needs of those who use this service can effectively be met. There are clear lines of accountability and responsibility and everyone who works at this service is provided with details of how their role fits into this structure. The manager and deputy manager are super numery to the staffing rota and ancillary staff are also employed. Specialist staff also visit whether this is to provide advice, support and therapies. The staffing levels provide for one to one support, which creates the opportunity for supporting people to participate in leisure and social activities and generally be involved in the wider community. Staff files were examined during this inspection and it was seen that the necessary diligence with recruitment procedures is being applied. Pre employment background checks have also been properly been completed in order to ensure the safety and well being of everyone who uses the service. The staff team have access to a comprehensive induction, professional qualification Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: and general training and development programme. As most of the staff team are new employees within Independence Homes their first appraisals are soon to take place and the organisation is committed to ensuring that these lead to individual training and development plans being established. As the home has only been in operation for a few months the effectiveness of these systems will be examined again at the next inspection. A monthly pre planned supervision schedule is in place. Again, as the service is so new it is too early to assess the effectiveness of this, but this will be examined again at the next inspection. Care Homes for Adults (18-65 years) Page 23 of 28 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, puts them as service users at the forefront in decision making about how the service is run and properly considers the need to keep everyone safe. Evidence: A Registered Manager is in place and she has successfully achieved the NVQ level 4 in management in care and Registered Managers award. The manager is experienced and has worked in this field for 7 years. She has managed a registered care home for young adults with learning disabilities for 6 years. The Registered Manager is responsible for ensuring that the policies and procedures of the organisation and home are implemented. The Registered Manager has a clear job description that sets out her roles and responsibilities to ensure the home is managed in accordance with the care standards act and all other legal requirements. The service has clearly been established in a well planned and thoughtful way and this is evident by just how well the home has commenced operating. It is too early for the service to have carried out a full annual quality assurance audit, however, feedback is Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: being sought from everyone who has an interest in how the service is running. Health and safety was examined in detail as a part of the original registration of the service last year so it did not need any specific re assessment at this particular inspection. It should be noted that the service was found to have effective systems and safeguards in place to protect those who live and work here from fire and other hazards. Comprehensive policy and procedural guidance is in place. Monthly monitoring visits by a senior manager of Independence Homes occurs at the required frequency and this demonstrates that there is the necessary diligence in organisational oversight of the service. Care Homes for Adults (18-65 years) Page 25 of 28 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 Care Homes for Adults (18-65 years) Page 26 of 28 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 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 Care Homes for Adults (18-65 years) Page 27 of 28 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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