Care Home: Lewisham Park, 40

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What the care home does well There is a good and welcoming atmosphere in the home and good interaction between staff and residents. The staff help the residents in activities, and provide support for in house and community activities. Staff know residents well and communicate well with them always speaking in a friendly and respectful manner. The home has provided a continuity of care since the residents came to live in the home approximately nine years ago. Both residents have active lifestyles that include social activities as well as education, work and personal development. The home is well decorated and maintained and resident`s rooms are well maintained and reflect their own choices and preference.The manager provides a sensitive and encouraging approach to managing the home, and tries hard to ensure that residents are safe and secure in the home, and has done much to provide opportunities for residents to have a normal stimulating and independent lifestyle. What has improved since the last inspection? The overall Star Rating for this home, as assessed by CSCI, has improved from One Star, Adequate to Two Star, Good, as a result of this key inspection. Residents have been made safer when going out in the community, and in doing things in the home because risk assessments have been improved and now include more information about how to avoid unnecessary risk to residents. The home have in place an ongoing preventative health care check for service users. Service users health, personal and social care needs are now better planned for, and reviews fully include advocacy, social services and each resident. Resident`s family members are now involved in their care planning. The owners who work at the home now have a better training plan for their development, and the manager has now completed an NVQ4 course in care and management. This will help the homes management to be better informed. There is now a plan in place for making improvements to the service provided, which involves asking for the views of residents, and others, about how the home is run. This helps residents to feel more included in all decisions about their home and their lives. What the care home could do better: The home should think about making more use of pictures in residents care plans, Person Centred Plans and in the weekly plans for resident`s activities so that both residents can understand these without having to ask staff. There should be some consideration given to including structured skills teaching plans for residents in how to carry out household tasks to enable a higher level of understanding and independence. There must be more formal training provided for staff in the homes training plans in how to support people with learning disabilities, and regarding general health and safety issues. There should be formal training provided for staff in person Centred Planning and Skills Teaching. This does not mean that residents are not being adequately supported in these areas at the moment, but rather as a means of making sure that staff are fully aware and able to do their jobs. The manager should consider attending a briefing or training day on the requirements of the Mental Capacity Act to make sure that should the needarise he has a full understanding of the how the home should support residents to make important decisions about their lives. CARE HOME ADULTS 18-65 Lewisham Park, 40 40 Lewisham Park Lewisham London SE13 6QZ Lead Inspector Sean Healy Unannounced Inspection 21st January 2009 09:00 Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lewisham Park, 40 Address 40 Lewisham Park Lewisham London SE13 6QZ 0208 3141877 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) percival.drummond@gmail.com Mr Percival Fitzroy Drummond Ms Maise Melanie Bell Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2009 Brief Description of the Service: 40 Lewisham Park is a large property offering residential care for up to 3 residents with learning disabilities. The business status is that of a sole trader. The house is located in a residential area opposite a park, and close to public transport links. It does not accommodate the needs of wheelchair users. The house is spacious and the care is provided by the proprietor and manager and who live in the house with their two children. The house has the appearance of a family home and the resident’s benefit from this environment. There was one vacancy at the time of the inspection. The two current residents are brothers and have lived at 40 Lewisham Park for a number of years. The residents spend their day in various planned activities such as day care and voluntary work. Their evenings and weekends are spent at home or in leisure pursuits. Information about the service provided is made available to current and potential service users in the homes Statement of Purpose and Service Users Guide. The recent CSCI report is currently kept in a file in the living room and is accessible to residents. At 21st January 2009 the homes fees are set at between £2,059.00 and £2,650.00 per month for accommodation, and for all support services. This charge includes food provided. The local authority pays for this. Residents have to pay for other personal expenses such as hairdressing, transport and personal shopping. These fees and terms and conditions are set out in contracts provided to the residents. The provider email address is percival.drummond@Gmail.com Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality Rating for this service is 2 Star. This means that the people who use this service experience Good quality outcomes. This unannounced inspection took place on 21/1/09. The registered manager facilitated the inspection. One resident was present for part of the inspection but choose not to give detailed views about how they felt living at the home. Both residents provided completed CSCI inspection surveys outlining their views about how the home is managed. All comments received were very positive and reflected well on the homes management and support provided. The method of inspection also included discussion with the home’s manager and his wife, both of who provide the support for residents. The building was also inspected for health and safety, suitability for residents and for cleanliness. Resident’s records and other documentation about how the home is run were examined. These were generally seen to have improved in the quality of information and in their organisation. Care assessments and care plans and risk assessments were examined to check that care needs were being planned for, and the registered manager and the other main carer spoke with me about these plans, and about the plans for development of the service provided for residents. The home provided a written Annual Quality Assurance Assessment for this inspection containing information about how the home is managed. What the service does well: There is a good and welcoming atmosphere in the home and good interaction between staff and residents. The staff help the residents in activities, and provide support for in house and community activities. Staff know residents well and communicate well with them always speaking in a friendly and respectful manner. The home has provided a continuity of care since the residents came to live in the home approximately nine years ago. Both residents have active lifestyles that include social activities as well as education, work and personal development. The home is well decorated and maintained and resident’s rooms are well maintained and reflect their own choices and preference. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 6 The manager provides a sensitive and encouraging approach to managing the home, and tries hard to ensure that residents are safe and secure in the home, and has done much to provide opportunities for residents to have a normal stimulating and independent lifestyle. What has improved since the last inspection? What they could do better: The home should think about making more use of pictures in residents care plans, Person Centred Plans and in the weekly plans for resident’s activities so that both residents can understand these without having to ask staff. There should be some consideration given to including structured skills teaching plans for residents in how to carry out household tasks to enable a higher level of understanding and independence. There must be more formal training provided for staff in the homes training plans in how to support people with learning disabilities, and regarding general health and safety issues. There should be formal training provided for staff in person Centred Planning and Skills Teaching. This does not mean that residents are not being adequately supported in these areas at the moment, but rather as a means of making sure that staff are fully aware and able to do their jobs. The manager should consider attending a briefing or training day on the requirements of the Mental Capacity Act to make sure that should the need Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 7 arise he has a full understanding of the how the home should support residents to make important decisions about their lives. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents have the information they need to decide whether to live at the home and their care needs are fully assessed. Each resident has an up to date written contract with the home showing the care to be provided. EVIDENCE: The home has an up to date Statement of Purpose and Service Users Guide which were last reviewed on 20/1/09 and which now include information on fees and charges made and about staff training. These documents are well presented and easy to understand, and copies have been given to both residents. There are currently two male residents living in the home. Both of these have care assessments in place since they started living at the home. These were provided by Lewisham Partnership in December 2003. The assessments are full and comprehensive and fully describe the care and support needed. Care plans contain information from these assessments. Assessments overall describe the needs of the service users. At last inspection one resident had developed a health issue related to his heart, which has now been included in his assessment and care plans. Reviews minutes show that this and other Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 10 important care needs for both residents are being discussed with social services, advocacy and with relevant health care professionals. Both residents have been given a contract between themselves and the home, which shows the room they will have, the service and support they will receive, and the cost of the service. Lewisham local authority is responsible for paying fees and this is noted in these contracts. Overall the information provided about the service the home provides, the cost of this service, how residents are to be supported and the staff qualities and training are included in all the relevant documentation for the home and care is taken to help the residents to be aware and understand this information. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Resident’s needs are reflected in their care plans. The residents are supported to make important decisions about their lives and risk assessments do adequately protect residents and staff. EVIDENCE: Both of the care plans inspected showed that they had been reviewed in May 2008, and that both of the residents have had a Person Centred care planning system showing their likes and dislikes and things they would like to achieve. The manager has introduced a new system for care planning, which is very detailed and reflects individual residents support needs very well. There is a range of information about health and social care needs, and very detailed activities checklist is used every three months to identify which activities the residents are enjoying and which they would like to stop or replace with other activities. This is also used to identify where more help is needed to help to learn tasks such as using the telephone, doing housework, or personal care areas such as getting dressed. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 12 There is a full range of activities scheduled on a weekly planning sheet for each resident, which show that they enjoy an active life within and outside of the home. Activities include: going to the library, games, music, writing, voluntary work at a school for one resident, and going to the pub and discos. Care plans also include a range of health care support needs and involvement from the GP, dentist, chiropodist and visits to the hospital with support when necessary. Good records are kept and the home has improved in its ability to formally plan for the care of residents. Both residents would benefit from the use of pictures in care plans and in weekly activity plans to enable them to read these plans more independently. (Refer to Recommendations YA6) Discussion with the homes manager and senior worker suggest that both residents may benefit from the use of more formal skills teaching planning in some aspects of domestic activities such as using the telephone or washing machine. It is recommended that the home explore whether this would be beneficial with both residents and their advocate and implement such plans if deemed appropriate. (Refer to Recommendations YA6) Both residents are supported to make decisions about a range of areas on a daily basis. The staff consisted solely of the Registered Care Manager and his wife provides the support needed. They are both very respectful in how they speak with residents, and I observed the residents being treated well and involved in discussion about what they did with their day when they returned home, and about what they would like to eat for tea. Residents have chosen how their rooms are decorated and the activities they want to do every day. Both residents’ money and finances are managed by the Registered Care Manager, and when residents were spoken to about this at the last inspection they said that they are happy with this and that they can get money when they need it. I was not able to speak with them about this subject at this inspection. It was recommended at the last inspection for the home to include more detailed instructions in risk assessments regarding risk to residents with more description as to how the resident is to be supported. This has now been done and there are a full range of risk assessments for each resident identifying the risk involved and how to minimise the risk. Risk is well managed in the home. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The residents have opportunities for personal development, links with the local community and access to appropriate social and leisure activities. They are supported to have appropriate relationships, and have a healthy diet. EVIDENCE: Overall the home provides a normal living environment living with residents sharing communal living areas with the owners of the home, while also having their own private space. This provides a warm welcoming and friendly atmosphere, which is welcoming for visitors. The home has no restrictions placed on visiting times and residents are able to have friends visit if they choose. Both residents have individual programmes of activities showing the things they like to do, which have been updated since the last inspection. The system Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 14 for care planning includes clear a description of the activities residents like to engage in, and also shows how residents own ideas are included in new care plans. The staff are help the residents to go out and there are activities clearly identified that residents can do without staff support. Activities they have been involved in include: attending day centre, some voluntary work in the local community and educational and leisure activities. One resident attends Parkside Day Centre and has a voluntary job helping with cleaning and dishwashing. Each Wednesday, he has helped at a local school doing similar voluntary work. At the last inspection he said he really enjoyed doing this work. Both residents attend a local Catholic Church regularly and are supported to attend all church services. One resident’s voluntary job is coming to and end but the home have been proactive in negotiating support from Mencap to help him find another job. There is a full range of activities scheduled on a weekly planning sheet for each resident, which show that they enjoy an active life within and outside of the home. Activities include: going to the library, games, music, writing, voluntary work at a school for one resident, and going to the pub and discos. The home’s manager has a system for checking whether residents are happy with their activities every three months and for offering extra help if needed, or when necessary changing activities if residents no longer enjoy them. At the last inspection contact had been made with a long lost family member of one resident and good work had been done to forge a new relationship between them. As a result this relative had extended an invitation to the resident to visit him at his home in Portsmouth. Since that time the relationship has continued and there is now involvement from this family member on a regular basis. Residents have constant contact on a daily basis with the owners and Registered Manager of the home, who provide them with support. No other staff are employed. There is a good relationship between the owners and both residents. Communications between the staff and residents is good and staff are very respectful in how they communicate with and about residents. Both residents have support from a long-term friend who acts in the role of advocate for them in their decision making and planning. This relationship has been fostered and encouraged by the home and is very beneficial for both. Good and nutritious meals are provided and both residents are involved in shopping and cooking, and always are given a choice of food at every meal. Menus are kept and residents said that the food is very good. Hall offers residents a choice of food a daily basis using a pictorial menu, which shows pictures of all of the meals on offer. These pictures have a number beside them and this is used to record what has been eaten. The use of pictures seems to greatly help residents to make quick and easy choices. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 15 Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Residents do receive appropriate and sensitive personal care support, and physical and emotional needs are met. Healthcare needs are fully supported and support with medication is appropriate for the residents assessed needs. EVIDENCE: Personal care support plans are in place for both residents, which are adequate and up to date. The residents are supported with personal care by the homeowners. One is very independent and more support is required for the other and this is reflected in the care plans. The care plan for each resident includes a good health care support plan, which fully meets their health care needs. Both are registered with a GP and dentist and have appointments with them at least every year. There is not involvement from many other healthcare professionals but this is appropriate to the assessed needs of the residents. At last inspection one resident had developed a heart condition and his care plan and health care records showed Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 17 that he was receiving appropriate treatment for this. This continues to be the case and he is supported to lead a full and active life. The homeowners know both residents very well, and are familiar with their needs. Neither resident is on any medication at present. Both are able to access the local GP and dentist as needed. Both the homeowners were able to demonstrate that they understood the residents differing emotional needs and how to offer appropriate support to each. In response to inspection surveys both residents said that they are happy with the support that they receive. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents do feel their views and concerns will be listened to and acted on and are protected from abuse and self-harm. EVIDENCE: The home has an up-to-date complaints policy, which was reviewed in July 2008. Neither the home nor the commission has received any complaints since the last inspection. In response to CSCI inspection surveys residents said that they have never complained and are happy living at the home. The residents have daily contact with the registered manager who provides support for them, and communications seems to be very good between staff and residents. Both residents have support from a long-term friend who is in regular contact with them and who can provide support to complain to the home should the need arise. The home has an adult protection policy in place, which was reviewed in July 2008. There have been no allegations or referrals made under the adult protection policy since the residents moved into the home in 2003. There are adequate procedures around safeguarding the resident’s money, and the home is not responsible for any of the residence bank accounts or benefits. These are managed by the local social services. Receipts are kept for all transactions and good written records are kept of all expenditure on behalf of residents. The home has a simple guidance for how to identify and report and protection issues, which includes a list of contact details for social care professionals in Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 19 the Borough of Lewisham. Social services are involved in annual care reviews for both residents. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26 and 30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home is homely, comfortable clean and safe, and bedrooms are comfortable and personalised. The needs of the residents are fully met within the home. EVIDENCE: As at the last inspection: The home is situated in a large Edwardian house, situated in a crescent overlooking Lewisham Park. The residents have access to all the downstairs rooms and the garden. There is a large pleasantly fitted bathroom on the first floor that they share with the rest of the family. There is one bathroom with a toilet on the first floor and a separate toilet on the ground floor. The home is suitable for the needs of both residents who have said that they like living with the family. It is homely and comfortable, well maintained and well heated and ventilated. It is not suitable for wheelchair users but none of the existing service users have this need. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 21 The home provides a normal living environment living, with residents sharing communal living areas with the owners of the home, while also having their own private space. Both residents share a room on the first floor. Both have confirmed that it is their choice to share and they are very happy with this arrangement. Their room is large and pleasantly furnished, with a TV and two armchairs placed side by side for them to watch TV. Their were numerous personal items around and was a pleasant and homely environment. The home is very clean and well decorated with good natural light throughout. Laundry is done separately and the machine has a sluicing facility. The home is very well maintained and there are no outstanding repairs required. The homes management are very active in quickly carrying out any repairs and decoration necessary, which keeps the home in excellent condition. The owners take care to ensure that residents are involved in choosing colour schemes when decoration is being carried out, and in making sure that all aspects of the home are domestic and homely and non institutional. The dining room is large with a large window allowing good sunlight onto the room. However sometimes when the sun is strong this can have a blinding affect when sitting at the dining table. It is recommended that consideration is given in consultation with residents for use of appropriate sunscreens or blinds for this window. (Refer to Recommendations YA19) Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported by competent and qualified staff and are protected by the homes recruitment policy and practices. Staff are now adequately trained to meet residents needs. EVIDENCE: The home now maintains very good clear records of all information regarding recruitment, induction and training, and now ensures that all of the necessary information is available at the home. The homes owners have made significant improvements in the record keeping systems for employment and training and these are now clear, well organised and easy to find. As at the last inspection the owners of the home employ no staff, and provide all the support to residents themselves. The independence levels of the residents suggest that this staffing arrangement is adequate and appropriate. As the home employ no staff there is no rota or records of recruitment/employment other than that of the owners. The arrangements for staff cover is that one of the owners will always be at home when any of the residents are at home. One of the residents said that there is always one of the Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 23 owners available at the home when they are at home. Both of the owners, now have completed training to NVQ Level 2 and 3, and the manager has now completed NVQ4 in care and management. Both owners showed a knowledge and understanding of the needs of the residents. They are respectful in their approach to communicating with them, and maintain a professional boundary when sharing the homes facilities. Both residents said in their inspection surveys that the owners respect their privacy and only go into their room with their permission. As the owners are the only staff working at the home, there are no recruitment records for inspection. The local authority, Lewisham Partnership, holds the CRB documentation for the care manager and his wife and copies were available for inspection. These were updated on the 13/12/07 and 3/1/08 and showed no issues for concern. There is a training record in place for both of the owners, and a list of training is available showing training completed. At the last inspection there was not a training plan in place for them, and a requirement was made for an improvement to be made in the formal training and development plans for both owners. This has now been done and this requirement is now met. There are now individual training plans in place. Examination of the training recorded for both owners showed that previous gaps in training records health and safety, fire safety, first aid, care planning, basic food hygiene and medication had now been addressed, and there are now complete records of training available at the home. However other important training in management of Learning Disabilities and health and safety still needs to be brought up to date. It is now required that both these areas be included in the homes training plans for staff. (Refer to Requirement YA35) It is also the case that formal training in Person Centred Planning and Skills Teaching both of which are beneficial to service users development do not yet form part of the homes training package. (See Standard 6 in this report) It is recommended that the owners consider including these areas in the homes training prospectus. (Refer to Recommendation YA35) As at the last inspection the home has an induction system in place and is in the process of reviewing the homes training and induction programme in consultation with Skills for Care. This is a positive step in bringing the core training for the home up to date. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The home is well run, and the manager now has appropriate qualifications. Residents views are now fully included in the homes development plans. Health and safety needs are being fully addressed by the home. EVIDENCE: As at the last inspection the home is well run and both owners were able to demonstrate a positive and committed approach to the residents that they provided care and support to. The ethos of the home is very much that of offering a care service within the setting of a family home. The manager is experienced in the learning disabilities area of care provision, and communicates very well with the service users. He has now completed NVQ Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 25 level 4 in care and management meeting a requirement made at the last inspection. Comments from the residents of the home about how the home is run show that they are happy with the management and with the care provided. One commented that he can easily speak with the manager every day, and that he is listened to. I found that the manager and his partner are easy to speak with, and provide a professional and planned approach to providing support for residents, and there has been a significant improvement in meeting formal care planning needs for residents, training for staff and in general record keeping. The manager agreed that attending training on the Mental Capacity Act would be beneficial in gaining a fuller understanding of changes in legislation regarding capacity to make decisions and residents rights. This will enable a full understanding of the how the home should support residents to make important decisions about their lives. (Refer to Recommendations YA37) There was a repeated requirement made at the last inspection for the home to have an effective quality assurance system in place based on seeking the views of residents to enable these views to be included in the homes development planning. This requirement has now been met. The home now conducts service user surveys twice a year and includes advocacy and families in these surveys. There is a separate quarterly checklist system in use to find out whether resident’s activities are working well for them or whether changes are needed. Action is taken immediately to implement changes when necessary and this is reflected in care plans and weekly activity plans for residents. (See also Standard 6 of this report). The homes manager is in the home on a daily basis to ensure the environment is well maintained and that resident’s daily needs are met. Care is now taken to ensure that residents are able to speak up through use of advocacy and family, and they are invited to participate in care reviews. The health and safety policy for the home was reviewed in July 2008 and is upto-date. A full range of health and safety documentation for the home was checked and was found to be in order. Fire safety equipment is in place and complete records are kept of all fire drills and fire equipment maintenance. The residents have risk assessments, which adequately protect them from risk or harm, and these are reviewed by the home monthly. Health and safety in this home is well managed. Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA35 Regulation 18.1 a Requirement The Registered Provider and manager must ensure that specific training regarding working with Learning Disabilities and Health and Safety are included in the homes training plans for staff, to ensure that training fully includes the assessed needs of residents and that staff are fully informed. Timescale for action 30/06/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations The registered provider should in consultation with residents consider a wider use of pictures in resident’s care and activities planning to enable better independent understanding by residents. The registered provider should consider including specific structured skills teaching in residents care planning for some domestic or development activities as discussed in this report The registered provider should consider including formal DS0000025599.V373603.R01.S.doc Version 5.2 Page 28 2 YA6 3 YA35 Lewisham Park, 40 4 YA37 Person Centred Planning and Skills Teaching training in the staff training prospectus for the home The registered provider should attend training on the requirements of the Mental Capacity Act to gain a full understanding of the homes responsibilities in relation to changes in legislation in this area Lewisham Park, 40 DS0000025599.V373603.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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