Care Home: Wardley Street

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What the care home does well "...The staff help me...", was a comment received from a resident who spoke about how they enjoy living at the home, and that they are able to pursue their own interests, with the support of staff if necessary. Findings from this inspection indicate that there is a committed manager at the home who works hard to progress the service. What has improved since the last inspection? CARE HOME ADULTS 18-65 Wardley Street 2 Wardley Street London SW18 4LU Lead Inspector Louise Phillips Key Unannounced Inspection 9th April 2008 10:00 Wardley Street DS0000010236.V362068.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 Wardley Street DS0000010236.V362068.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. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wardley Street Address 2 Wardley Street London SW18 4LU 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) 020 8875 1293 /1336 www.odyssey-csft.org Odyssey Care Solutions for Today Ms Comfort Bonti Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 7 5th February 2008 Date of last inspection Brief Description of the Service: The home is located in Wandsworth, in a small cul-de-sac close to local shops, post office, public transport and other amenities. Thames Housing Association owns the building and Odyssey Care Solutions for Today, a charitable organisation manage the home. It is registered to provide care for up to seven service users with learning disabilities. The home is a purpose-built three-storey building. There is no passenger lift. All bedrooms are single including two of which are wheelchair accessible and these are on the ground floor, both with en-suite facilities. The home has an open plan lounge/dining room and a patio garden to the rear. Fees range from between £776.23 per to £983.00 per week. Wardley Street DS0000010236.V362068.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 stars. This means the people who use this service experience good quality outcomes. This inspection took place over one day and included a visit to the service by a Regulation Inspector. When we visited we spoke to the people who live and work at the home and the manager. We also looked at records, observed what was going on and looked at the environment. As well as the visit we asked the manager to complete a quality selfassessment. What the service does well: What has improved since the last inspection? What they could do better: Areas where the home could be doing better are highlighted in the report and were discussed with the manager during the inspection. These include improvements to the care planning and staffing of the service. The home also needs to ensure the safety of residents at all times and a requirement has been made to address a number of areas in the environment that can pose a risk to the residents. Please contact the provider for advice of actions taken in response to this Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 6 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. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 7 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 Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 8 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): 2 Quality in this outcome area is good. The resident’s needs are constantly assessed and there is current information available about the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents have lived at the home for varying periods of time. Their care files contain information about the referral and assessment prior to their moving to the home, with details about their physical health, personal care needs, important relationships, etc. Information has also been obtained from all relevant health and social care professionals, detailing any particularly significant areas such as communication and social needs. Staff said that each resident receives an annual re-assessment of their needs, with the involvement of the social worker, and evidence of this was seen in the care files. New residents moving to the service are offered day visits and overnight stays to help them decide if they want to live at the home, and records are maintained of this process. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 9 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. Staff have a good awareness of the physical and personal care needs of each resident. Improvements are needed to ensure that all the needs of residents are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident receives care on a one-to-one basis and observations during the inspection are that staff have a good relationship with the residents and a good awareness of their needs. All residents were individually dressed in smart, age-appropriate clothing, and one resident said that they are able to choose what they would like to wear each day. The care files for a number of residents were looked at. These contain detailed information about the history, needs and interests of each resident. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 10 The manager described that a more person-centred planning (PCP) approach to care planning is being introduced at the home, and the initial stages of this was seen where photographs had been taken of residents getting involved in looking at what they like to do and plans for the future. Examples of this include photographs of individuals going out to places they enjoy, getting involved in tasks around the home, such as emptying the dishwasher and making breakfast, and also collecting their medication from the pharmacy. Staff spoke about training they had received in PCP with a lot of enthusiasm and interest, where one described it as “…incorporating the wishes and aspirations of service users, what they actually want and do not want, not what you think they need, like in planning the menu, holidays and daily life…”. PCP care plans have not yet been developed and the care plans currently in use are quite confusing, with the use of different headings, such as ‘maintenance plan’, ‘development plan’ and ‘teaching plan’. Areas covered under these headings include diet and nutrition, personal care needs and daily activities, and they are individualised to each resident. However, there is no evidence of the involvement of residents in the development or review of these. Also, the care plans for all residents are kept in one file, where it is recommended that individual files are developed for each resident, to ensure confidentiality. There are individualised risk assessments for each resident, which have also been forwarded into risk management plans, or ‘guidelines’ to maximise the safety of the residents. These are well detailed and include activities both in and outside of the home, such as making a cup of coffee, going out on own and socialising. In some cases there has also been identified potential triggers to risk behaviours, preventative techniques that staff can use, and also guidance on what they can do should an incident occur. The manager should ensure that these areas are incorporated into the PCP for each resident. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 11 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. Service users are supported to pursue activities and maintain community links. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On arrival at the home some residents were still in bed, and the staff explained that they are able to get up when they want to, and that some are supported to carry out daily activities. Evidence was seen on a timetable that throughout the week all residents are involved in either attending a day centre, going out with relatives or receiving one-to-one support to go out for lunch or shopping. Records are maintained of the one-to-one support that each resident receives, through the one-to-one worker maintaining a book of all activities carried out, recording in a ‘journal’ format their days out with the resident, photographs and brochures of events where they have accompanied a resident. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 12 During the inspection a support worker was observed talking to a new one-toone support worker, informing them of what the resident likes to do, where they like to go and any risk factors they need to be aware of. One resident said that they like going out with the one-to-one worker, as it helps them to go out and “…do what I want…”. Feedback from staff is that they feel the service is good at letting the residents choose what they want to do, where to go out and what they would like to eat. Meals at the home are chosen by the residents and prepared by the staff, with the involvement of some residents. There was seen to be a range of foods, fresh, frozen, tinned and dry goods to ensure that balanced meals are provided by the service. The fridge contained a number of opened/ decanted foods, such as butter, cheese and meats, which were all appropriately labelled with the date that they had been opened. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 13 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 as the resident’s physical and personal care needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff said that some residents need support with their personal care and this was documented in the care plans. Since the last inspection evidence was available to demonstrate that each resident had received an assessment of their needs with their social worker and home staff, to ensure that their care is up-to-date and kept under review. Good records are maintained of contact that residents have with health and social care professionals, and dietician and psychology services where necessary. Some residents take medication, which is stored and managed by the staff, with the involvement of the residents in the collection of this from the Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 14 pharmacy. Records are maintained of the receipt and disposal of all medications brought into the home. All medication and records relating to the administration of these were checked and no issues identified as needing to be addressed. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 15 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. The home has appropriate procedures for addressing complaints and ensuring that the residents are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has an appropriate complaints procedure that provides timescales in which any complaint will be acknowledged and investigated. This is also available in pictorial format for the use of the residents. The complaints log book details that there have been no complaints since the last inspection of the service. Records of the last complaint received at the home are appropriate, with a good record of the complaint and actions taken to manage this. The home uses the Wandsworth Safeguarding of Vulnerable Adults procedures, and there are policies and procedures regarding what to do in the event of an abuse allegation being made at the service. The staff training records indicate that most staff have received recent training in Safeguarding Adults, and training is planned for those who still need to attend this. Staff spoken to demonstrated a good awareness of what to do in the event of any abuse allegation being made at the home. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 16 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, 29 and 30 Quality in this outcome area is adequate. The environment is welcoming and homely, with some improvements needed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has taken steps to address previous cleanliness and hygiene issues at the home, with residents and staff involved in maintaining the environment. Improvements have been made since the last inspection, with the hallways and bedrooms having been redecorated. During a tour of the building some areas were identified as needing improving: - 1st floor, bathroom nearest to office – grouting needed on tiles and the bath seat is cracked and a potential health and safety risk, so needs replacing. Bathroom opposite – needs new toilet seat. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 17 - 1st floor, bathroom opposite that above – the handrail near the bath is in need of repair as it is loose and comes away from the floor. - ground floor, kitchen – is in need of modernising, also some doors are not in place or loose and there is no extractor fan cover. - ground floor, bedroom next to laundry – in the en-suite there are tiles missing from the walls. - ground floor, bedroom opposite that above - needs the rail next to the bath made good and replacement of the bath panel. - garden – need to repair the wooden door in the corner and remove the broken plant pot. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 18 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, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made as staff receive relevant training and support for their role. Some improvements are needed to recruitment checks to minimise the risks to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff have been working at the service for varying periods of time, and feedback regarding each person’s recruitment to the service was positive, with all stating that they had been interviewed and had received an induction to their role. The staff recruitment files are held at the human resources department for Odyssey. Following a requirement from the last inspection, a ‘schedule of information’ is held to verify that all recruitment checks have been carried out, and all relevant information is held about staff working at the home. The staff files hold evidence that a Criminal Records Bureau check (CRB) has been carried out on each member of staff. Some of these have not been Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 19 carried out since 2002 and it is recommended that these are updated to minimise any risks to the residents. One staff member spoke about having nearly completed their NVQ level 3 in Care, and that they are supported by the organisation to do this, with appropriate time off for study. Training records indicate that over the past year staff have undertaken training in medication awareness, infection control, safeguarding adults and food hygiene. The manager demonstrated ongoing training that staff will do over the coming year, such as first aid ad health and safety. The manager discussed that there are still a number of permanent staff vacancies at the service, and that these are currently being recruited for. Staff spoken to said that they feel well supported by the manager, with them being able to ask for extra support in addition to their monthly supervision sessions. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 20 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 as the manager is competent and understands the responsibilities of their role. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Feedback from staff is that they feel there is good management at the home and that they are able to be involved in the development and progression of the service. One staff member stating that: “…the service is well managed…”. The manager has worked at the home for a number of years and demonstrated a good understanding of areas that need improving and the development of the service. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 21 Regular staff meetings are held at the service and the minutes of these demonstrate that they are used to discuss relevant issues such as those regarding residents, and ideas exchanged for managing specific issues, such as safety. Residents are able to air their views at the monthly residents meeting. Notes from these meetings demonstrate that topics such as menu ideas, maintenance and house issues are discussed, along with residents being informed of any changes within the service such as the re-decoration and when this was due to start. Appropriate health and safety checks are carried out around the home, with records to demonstrate that up-to-date checks had been done on the electrical installation, gas safety, portable appliances and water temperatures. The service needs also keeps good records to demonstrate that fire systems and fire safety equipment are checked and maintained regularly. Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 22 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 X 2 3 3 X 4 X 5 X 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 2 25 X 26 X 27 X 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 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 Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 YA6 & YA7 Regulation 12(2)(3) Requirement The care plans need to demonstrate a more person centred approach and the involvement of the residents. (Previous timescale of 01/07/07 not met) 2. YA24 & YA27 23(2)(b)(c) The Registered Persons must ensure that all areas identified on pages 17 and 18 of this report are addressed within the timescale. 18 (1)(a)(b) The organisation must ensure that there are sufficient numbers of qualified permanent staff to ensure consistency for the residents. (Previous timescale of 01/07/07 not met) 31/08/08 Timescale for action 31/05/08 3. YA33 31/05/08 Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 24 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 & YA7 Good Practice Recommendations It is recommended that the care planning system in place be reviewed to ensure that it is an effective working document for staff to use in conjunction with the service user. The manager should ensure that areas of risk are incorporated into the PCP for each resident. Consideration should be given to installing a new kitchen at the service. It is recommended that an up-to-date CRB check is carried out on each member of staff, to minimise any risks to residents. 2. 3. 4. YA9 YA24 YA34 Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI Wardley Street DS0000010236.V362068.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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