Care Home: Oval Road (170)

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Oval Road (170) 170 Oval Road East Croydon Surrey CR0 6BN 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: Janet Pitt Date: 1 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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: Oval Road (170) 170 Oval Road East Croydon Surrey CR0 6BN 02086869814 T/F02086869814 mbheecarry@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Mercidita Bheecarry,Mr Mike Bheecarry 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 - 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: 3 Date of last inspection A bit about the care home 170 Oval Road is a terraced house located in a side street a few minutes walk from East Croydon Station. It is a small care home registered to support three adults with learning disabilities. Bus and tram services also serve the local area. 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: This is what the inspector did when they were at the care home The quality rating for this service is two star. This means the people who use the service receive good quality outcomes. The last key inspection was undertaken on 30th November 2006. One inspector undertook this unannounced inspection. A site visit was made that lasted two and a half hours. During the visit the manager and the deputy were spoken with. None of the people who live in the home were there as two people had gone to a day centre and one person had gone to visit relatives. Records relating to care, medication and staffing were inspected. A tour of the premises was undertaken. The home completed an Annual Quality Assurance Assessment [AQAA] which was also used to inform this report. Current fees are in the region of five hundred and seventy pounds per week dependant on care needs. What the care home does well Oval Road provides a homely environment for people to live in. The manager and staff team are proactive in making sure that people are treated as individuals. Care planning is person centred and involves the person. Activities are tailored to peoples preferences and abilities. Staff are able to attend appropriate training to make sure that they are suitably skilled to care for the people that live in the home. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Janet Pitt Caledonia House 223 Pentonville Road London N1 9NG 020 7239 0330 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who chose to live at Oval Road can be confident that their needs will be assessed and recorded. Individuals are included in the process and are support to indicate what their needs are. Information from other professionals and the placing authority is incorporated into the assessment. Evidence: Peoples assessments were noted to be person centred and included the information required in the Standards. There was information from the placing authority that covered health and social needs. Individuals religious needs were noted and whether they were practising or not. The home did not have any vacancies at the time of the site visit and people had lived there for a few years. The provider/manager stated that she undertakes assessments. The deputy is also involved in this process. The home places good emphasis on developing staff to there full potential, the deputy is currently undertaking NVQ level 4. 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 service involves individuals in the planning of care which affects their lifestyle and quality of life. Staff understand the importance of residents being supported to take control of their own lives. Individuals are encouraged to make their own decisions and choices. Care plans are person centred and agreed with the person and contain appropriate assessment of risks. Regular reviews are held that reflect the changing needs of the person. Evidence: The homes AQAA states: Each service user has a care plan with detailed information on their needs and personal objectives... they have individual risk assessments... so that they can participate in activities in the home and in the community in a safe manner. The AQAA also indicates that they need to improve risk assessment around travelling and safety on the road. When we examined peoples care plans we found that each person had an individualised risk assessment. Areas covered include use of the washing machine, acceptable social boundaries when in the community and independent travel. Plans were seen to be reviewed on a regular basis with the involvement of the person. Referrals to other professionals had been made as needed. For example psychiatrists, dentists and opticians. The manager reported that the people who live at Oval Road were not in as they were at college. She also said that regular outings to places like restaurants were made to assist with individuals social skills. Evidence: We found that minutes of meetings held with the people that live in the home confirmed that they are able to express their views on activities, menus and holidays. The ethos of Oval Road is to enable people to become independent and develop skills in a supportive environment. We discussed with the manager the need to have a recent photograph of an individual either on the care plan or medication record. 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 . People who use the service have the opportunity to develop and maintain important personal and family relationships, and are able to access information and specialist guidance about issues such as intimate relationships. Staff practices promote individual rights and choice, but also consider the protection of individuals in supporting them to make informed choices. People are involved in meaningful activities of their choice, according to individual interests. When appropriate people are involved in the domestic routines of the home and take responsibility for their rooms, menu planning and communal areas of the home. Evidence: We found that people who live at Oval Road are able to maintain contact with their family and friends. There was evidence in care plans of people being able to telephone their families or visit them. The manager said that at the moment no one has a partner, but in the past they have supported individuals to develop and maintain relationships. We discussed the homes Christmas arrangements and the manager reported that some people would spend the time with their families. Other people who chose to stay at Oval Road would be participating in festive activities with the people who live two doors away in the managers other home. She said that all the people who live in both Evidence: places socialise and have meals together. The neighbours are friendly and speak with people who live in the home when they see them. The AQAA also states that peoples rights are respected and responsibility is recognised in their daily lives. Individuals are able to contribute to the planning and running of the home on a daily basis. During the site visit we were able to see evidence of activities and outings people had participated in. There was a notice board with photographs of trips to places like Edinburgh and the seaside. We were told by staff that there are plans to go to London shopping and a holiday abroad. One person takes pride in completing jigsaw puzzles and needlework, their work had been framed and hung on the wall. Another person has a baby (a doll) that they care for like a real baby and staff are instructed to care for the baby when the person is out of the house. Another person has been able to start drama workshops, this interest was identified on admission. We were told that mealtimes are flexible and people are able to chose what they eat. The home plans to involve individuals more with meal preparation in the home. The deputy reported that visits are made to local markets, like Surrey Street, to buy fresh food. Individuals are actively encouraged to buy items from the shopping list themselves and handle money. The manager reported that people are expected to learn domestic skills as part of their care plan, but she makes sure that these skills are demonstrated by staff first and people are supported. 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 . People who live in the home can be confident that health and personal care needs identified will be met. They are encouraged to manage needs independently. Staff make sure that a persons privacy and dignity is respected. People are protected from harm by the medication handling and administration in the home. End of life wishes are recorded if a person chooses to discuss them. Evidence: We found that care plans lead from the assessment and included detail of how individual needs were to be met. The plans were regularly reviewed and person centred. The AQAA stated that where support is required with physical care [this is] outlined. Medications were handled safely in the home and each person had regular reviews of their prescribed medicines. Records of administration showed that only necessary medications were given and they were maintained accurately. People are able to self medicate if a risk assessment indicates that this is appropriate. Specific needs such as continence promotion are handled in a sensitive manner and the individual is supported to be self caring. Training is accessed for staff to make sure that they can support people with health needs correctly. 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 . People who live in Oval Road can be confident that any concerns or complaints they have will be acted upon. They are protected from harm by training given to staff on Safeguarding and implementation of this training. Evidence: The homes AQAA states that they have not received any concerns or complaints. Oval Road value peoples views and encourage individuals to raise any concerns with members of staff. There is a complaint book available that people can use if they do not wish to voice any concerns they may have. The homes AQAA indicates that all staff have attended training on Adult Protection and this is being implemented. We have not received any complaints and there have been no Safeguarding Adult investigations. 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 . People live in a homely, comfortable environment. They are able to personalise their rooms and have their own belongings. Individuals are actively encouraged to chose the decor of the home and how furniture is arranged. Evidence: People live in a home that is domestic in nature. There are suitable communal areas which include a sitting room, dining area and day centre room for activities. The kitchen is of a suitable size to enable staff to work with individuals when preparing meals. Each person has their own bedroom that they are able to chose how to decorate. No issues with health and safety were identified. the homes AQAA states that they will continue to maintain regular checks of hazardous equipment and make sure that smoke detectors are serviced regularly. There is a level garden to the rear of the property and the manager reported that people have raised pots for plants and vegetables were grown in the summer months. We found no issues with cleanliness on the day of the site visit. 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 . Oval Road is staffed efficiently and flexibly. Safe recruitment procedures protect the people that live in the home from harm. Individuals are cared for by staff who are suitably trained and competent. Evidence: The home indicates in its AQAA that staff know their roles and responsibilities ,[there is] good team work and [staff] are competent with their job. When we examined staff files we found that there was a good recruitment process in place that protects people from harm. Contained in the files were copies of permissions to work and proof of identification. Each person had an application form and two references. Supervision of staff was noted to be planned and carried out. The deputy reported that training was available for all levels of staff and recent training had included information on the Mental Capacity Act. The manager promotes good practice, with the majority of staff having already achieved NVQ level. Others that do not have this qualification are currently working on the award. The AQAA also indicates that when staff have received training then information form this is fed back to other staff members at their meetings. Staffing of the home is flexible dependant on what the people who live there want to do. 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 . People live in a home that is well managed and run. Emphasis is placed on making sure that their views are listened to and acted upon if necessary. The AQAA indicates where the home needs to make improvements and how this is going to be achieved, but needs some more detail to make sure that it is clear what aims Oval Road has. Evidence: The manager has achieved the Registered Managers Award and is registered with us. She said that she had twenty years experience in running Oval Road and that the people who live there are the focus of her work. Care has been taken to make sure that people are involved in the running of the home and have their say on what happens. The AQAA indicates that there is a Quality Monitoring System in place. People are able to give formal feedback on the care they receive and the home plans to review relatives questionnaires to make sure that they are able to participate and make their views known. Throughout the AQAA and during the site visit it was evident that policies and procedures relating to the running of the home are live documents, with regular reviews and amendments being made if needed. Staff are made aware of any developments in practise through staff meetings, training and supervision sessions. Evidence: Care is needed to make sure the AQAA is sufficiently detailed to show how improvements are to be made i.e. use of how, where and when in explaining what is to occur to achieve change. 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 6 17 There must be a recent photograph of the individual either in the care plan or medication records. 27/02/2009 This will make sure that each person is easily identifiable and protect them from harm. 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 1 39 It is recommended that the AQAA contains more detail on how improvements are to be made. This will give a clear indication of the direction the home is moving in. 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 © (2008) Commission for Social Care Inspection (CSCI). 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