Care Home: Porchester House & Pelham House

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What the care home does well Porchester House and Pelham House provide a homely environment for the people who live there. Bedrooms have been personalised and we saw people to be comfortable in their rooms and communal areas. Information about the services provided, how to make a complaint and care planning is provided in pictorial and written format, making it more accessible to the people who use the service. An advocate visits regularly and chairs residents meetings every three months, providing people with a good opportunity to give their opinions about the services provided and raise any concerns. Staff have access to training and support to help them do their job. What has improved since the last inspection? This is the first inspection of the home since it was taken over by the organisation Odyssey Care Solutions for Today, an organisation that has a large number of similar services in South London. What the care home could do better: The Statement of Purpose and Service Users Guide should be updated to include details of the new providers and the correct details of the CSCI, to ensure people who use the service and their representatives have up to date information. A protocol or procedures should be developed for staff to follow when people who use the service spend their money on large items of furniture, with records kept of who was involved in the decision. The hall and staircase on second floor should be redecorated to keep the environment to a good standard for the people who live there. The manager told us they want to recruit some new staff who are able to drive, to help people who use the service access the wider community. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Porchester House & Pelham House 69 Croham Road South Croydon Surrey CR2 7HF     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: Emma Dove     Date: 2 8 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Porchester House & Pelham House 69 Croham Road South Croydon Surrey CR2 7HF 02086801041 02086801041 Telephone number: Fax number: Email address: Provider web address: www.odyssey-csft.org Name of registered provider(s): Type of registration: Number of places registered: Odyssey Care Solutions for Today care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 9 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 Date of last inspection Brief description of the care home Porchester House and Pelham House are two flats within a large house in a residential road in South Croydon. One flat on the ground floor can accommodate four people, the other flat, on the first and second floor can accommodate five people with learning disablities. Nine people are currently living there. The home is managed by Odessey Care Solutions for Today, which operates a large number of similar services in South London. 9 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was carried out over four hours on the 28th January 2009 by one regulation inspector. We spoke with people who use the service, staff and the deputy. We received an annual quality assurance assessment (AQAA) on the 3rd February 2009, five weeks after it was due. This document gave us good information about the service, what is does well and the development plans for the next year. We looked at other information received from the service since it was taken over by a new organisation and registered in August 2008. Care Homes for Adults (18-65 years) Page 5 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 26 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 7 of 26 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 service understands the importance of having information to help people decide to move in. People thinking about moving in are invited to visit, meet other people living there and staff. A detailed assessment by placing social workers is used to ensure the service is the right place for the individual. Evidence: We saw the Statement of Purpose and Service Users Guide, available in both written and pictorial format which are accessible to people who use the service. They contain information about the home, the service provided, the philosophy of care, residents rights, staff and some policies. These documents need updating to include details of the new providers, new staff and correct contact details of the CSCI. We didnt see assessments from when people moved in, staff told us this was many years ago and individuals needs have changed since then. We did see details of the care and support people currently need. The deputy told us that everybodys needs had been reassessed last year, before the new providers took over. Care Homes for Adults (18-65 years) Page 8 of 26 Evidence: People told us they are happy here and I like my room. We saw people to be comfortable in their bedrooms and communal areas. Care Homes for Adults (18-65 years) Page 9 of 26 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. People who use the service are involved in developing and reviewing their care plans and making decisions about their future. Care plans and support is person centred. Risk assessments are completed and kept up to date. Evidence: The manager told us the service operates a key work system, where one member of staff works with an individual, developing and reviewing a care plan, writing reports for the placing social workers, arranging annual reviews and keeping everybody involved including relatives, representatives and staff up to date with any changes. Staff were clear on their key work responsibilities and were seen to work well with individuals during our visit. We saw case files include detailed information about the individuals past, their daily activities, what they like and health information. Staff told us they are developing new care plans with individuals, using the local authority format, which are more person Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: centred. We saw information in written and pictorial format which is accessible to the people who use the service. People said they spend time with staff and family members talking about what they need and want. We saw risk assessments in place which cover: eating meals safely; community activities and safe environment. The risk assessments seen had been updated and staff were aware of the actions they need to take to minimise risk for individuals. Staff are aware of the balance between risk and allowing people to live the lives they choose. Care Homes for Adults (18-65 years) Page 11 of 26 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 service is committed to enabling people who use the service to maintain and develop their social, emotional, communication and independent living skills. People are involved in community activities. People are supported to keep in contact with family members and friends. The service provides a varied menu that caters for individuals likes and any medical, religious or cultural needs. Evidence: We saw people watching television, spending time with staff, visiting a relative, relaxing and going out to the bank with staff during our visit. We saw people to be relaxed and comfortable in their surroundings. A member of staff is employed five days a week who does both one to one and group activities and sessions. This is good for the people who use the service, because it provides some regular opportunities and some new and different experiences for them. We spoke to this member of staff who showed a commitment to providing good experiences to people who use the Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: service and has a good knowledge of the individuals and their likes and dislikes. Staff told us that people go out shopping, to the hydrotherapy pool, trampolining, cycling, for walks and that a person visits the home to do music sessions. Staff do hand and foot massages with individuals. One person confirmed that they go out regularly and do things they like. Staff told us people keep in contact with family members and friends. We saw someone be out with a relative during our visit. One person told us they see their parents at the home. We saw a varied menu and staff told us this has been developed with a dietician to meet peoples medical, religious and cultural needs as well as their likes and dislikes. One person told us they like the food. We saw a record of the food individuals have eaten, which shows that they are eating a balanced diet. Care Homes for Adults (18-65 years) Page 13 of 26 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. Peoples healthcare needs are recorded in health action plans and met by staff. Medication is well managed. Evidence: The manager told us they work closely with other professionals to meet peoples health needs. We saw records of regular checks with the dentist, chiropodist and an annual health check with the GP. Staff said they weigh people every month and any issues are referred to the GP or dietician. We saw records of people weight. We saw two people were unwell during our visit, staff had contacted the GP and were taking advice given to help the individuals get well. Medication is appropriately stored and medication administration record sheets are up to date and signed by staff. We checked the records and balance of medication for two people. Both were signed and the balance correct. Good systems are in place to check medication every week and staff were clear of the actions to take if someone had Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: missed a dose. We saw clear guidelines for staff for as required medication. Staff told us they have had training in medication administration. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a clear, accessible complaints procedure which is included in the Statement of Purpose and Service Users Guide in pictorial and written format. Policies are in pace for safeguarding and staff have completed training in the protection of vulnerable adults. Evidence: We saw a complaints procedure, accessible to people who use the service. Information about how to make a complaint is included in the Statement of Purpose, Service Users Guide and contract of residence. The manager told us, in the annual quality assurance assessment, that they had received one complaint in the last year, although we didnt see information about this at the home. The manager told us staff have completed training in the protection of vulnerable adults, staff confirmed that they have done this training. We saw records confirming staff have completed training in safeguarding through the local authority and the organisation. We saw the financial records for one person, the balance was up to date and correct, receipts are kept for all transactions. We noted that some large items of furniture had been purchased by one person. The organisation must make sure that records indicate Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: who has been involved in decisions to buy large items of furniture and this must be kept in the individuals case file, to ensure the individuals finances are used appropriately. Care Homes for Adults (18-65 years) Page 17 of 26 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 home is appropriate to meet the needs of the people who live there. People have their own rooms which they have personalised to their choice. Sufficient bathrooms and toilets are available. Evidence: The house is separated into two flats, with each area having bedrooms, toilets and bathrooms, lounge, dining area, a kitchen and a laundry. The ground floor has four single bedrooms and a conservatory with doors to the garden. The first floor has five bedrooms and the kitchen, dining room and laundry are on the second floor. We saw people moving around between the flats and staff confirmed this is usual, although they have separate flats, people are able to spend time in either, depending on the activities taking place and their preference at the time. We saw bedrooms are single and have been personalised to the individuals taste and preference. There are sufficient bathrooms and toilets to meet the needs of the people living there. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: A number of improvements have been made to the environment since the last inspection with carpets replaced in the hallways and some bedrooms, an airconditioning unit fitted in the kitchen on the second floor and door closers fitted to some rooms, meaning the doors are not wedged open. All areas were clean. Care Homes for Adults (18-65 years) Page 19 of 26 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. Staffing levels were seen to be sufficient to meet the needs of the people who use the service. Staff have access to training and support to provide the care the individuals need. Evidence: We saw staff levels to be sufficient to meet the needs of the people who live at the home. The staffing rota identified two members of staff on duty in each flat during the day and one member of staff in each flat, awake at night The manager, activities worker and domestic staff are available in addition to these numbers on week days. The manager told us that staff have access to training through the organisation and have completed training to NVQ level 2 and done training in medication administration, food hygiene, health and safety, first aid, autism and learning disability. The manager has recently completed a training needs analysis for the staff team and is aware of the training staff need to bring them up to date, this includes medication administration, fire safety, learning disability and communication. Staff told us they get training to help them carry out their role. The organisation has a staff supervision schedule which means staff have supervision Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: every month. We saw records confirming that staff have regular supervision. Staff told us they have the support they need to do their job. Staff meetings are held every month and we saw the minutes of the last meeting. A staff meeting was due the day after our visit, the agenda was displayed and staff told us they can add anything they wish to discuss. Care Homes for Adults (18-65 years) Page 21 of 26 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 manager has the skills and experience to run the home. The organisation has quality assurance systems to check the care and services provided on a monthly basis. Health and safety is well managed. Evidence: The manager has been at the home for fifteen years and has experience in other similar services. The organisation has quality assurance systems which include a visit to the home every month by a manager, who speaks with people who use the service, staff and checks records. Any issues are raised with the manager and checked at the next visit. An advocate visits the home on a regular basis and holds a residents meeting every three months. They have known the people who use the service for many years and are aware of their needs and is able to raise any concerns. Staff said having an advocate chair the residents meetings and visit the home on a regular basis is good for the people who use the service and means they have an independent person who Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: can help them make any comments. We saw records of health and safety checks to be up to date and maintained in good order. Appropriate insurance is in place. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 1 The Statement of Purpose and Service Users Guide need updating to reflect the new providers, staff and correct contact details for the CSCI, to ensure people who use the service and their representatives have access to the right information. Clear guidance should be developed to protect individuals when spending large amounts of money, with records kept of who was invovled in the decision. The organisation should provide furniture in peoples bedrooms. 2 23 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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