Care Home: Woodbourne Avenue, 31

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What the care home does well The service users have enjoyable lives, they go to adult education classes and do voluntary work. They also enjoy social activities such as going out to the cinema, seeing their friends and family.The staff at the home make sure that they ask service users about how they want to be helped and what they hope to do in the future. This is written down in a way that the serviceusers can easily understand. The service users see the doctor or nurse when they need to and their health is well looked after.The staff team is well trained. Most people have worked at the home for a long time so the service users know them well. What has improved since the last inspection? Staff have had training so that they know how to care forpeople who are getting older.The manager and staff are thinking about how they can help service users to look after their own medication. What the care home could do better: We have suggested that the records of when a service user has a medication bought from the chemist shop should be written down on a separate page. Key inspection report Care homes for adults (18-65 years) Name: Address: Woodbourne Avenue, 31 Woodbourne Avenue, 31 Streatham London SW16 1UP The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alison Pritchard Date: 2 3 1 1 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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 Care Homes for Adults (18-65 years) Page 2 of 31 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2010) Care Quality Commission (CQC). 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 CQC 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 31 Information about the care home Name of care home: Address: Woodbourne Avenue, 31 Woodbourne Avenue, 31 Streatham London SW16 1UP 02087691865 02086770720 woodbou.hirch@btconnect.com www.ftf.org.uk Frances Taylor Foundation care home 8 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) : Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (CRH - 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 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home 31 Woodbourne Avenue is one of a number of care homes owned and managed by the Frances Taylor Foundation. This is a registered charity providing social, health and pastoral care services. This care home is registered to provide care and accommodation for eight adults with a learning disability. It is a three-storey semi-detached house located in a pleasant quiet residential street and just a short walk away from the busy shopping area of Streatham. There are a variety of leisure facilities, such as cinemas and restaurants and rail and bus links are close by. The premises provide a pleasant and homely environment. Bedrooms are single. There is a large well-kept garden to the rear of the home. There were no vacancies at the time of inspection. The charges range from £592 to £715 a week. Care Homes for Adults (18-65 years) Page 5 of 31 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home We went to the home on a day in late November 2009. We did not tell anyone that we were going to visit. While we were there we spoke to people who live and work in the home, we had a look around the building and we looked at paperwork. Before we visited the Manager had sent us information about the home and people who live there, their relatives and staff filled in surveys for us. Page 7 of 31 Care Homes for Adults (18-65 years) What the care home does well The service users have enjoyable lives, they go to adult education classes and do voluntary work. They also enjoy social activities such as going out to the cinema, seeing their friends and family. The staff at the home make sure that they ask service users about how they want to be helped and what they hope to do in the future. This is written down in a way that the service Care Homes for Adults (18-65 years) Page 8 of 31 users can easily understand. The service users see the doctor or nurse when they need to and their health is well looked after. The staff team is well trained. Most people have worked at the home for a long time so the service users know them well. What has got better from the last inspection Staff have had training so that they know how to care for Care Homes for Adults (18-65 years) Page 9 of 31 people who are getting older. The manager and staff are thinking about how they can help service users to look after their own medication. What the care home could do better We have suggested that the records of when a service user has a medication bought from the chemist shop should be written down on a separate page. Care Homes for Adults (18-65 years) Page 10 of 31 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 Alison Pritchard Regulatory Inspector Care Quality Commission CQC London Citygate, Gallowgate Newcastle upon Tyne, NE1 4PA Phone: 03000 616161 E-Mail: enquiries@cqc.org.uk Care Homes for Adults (18-65 years) Page 11 of 31 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 12 of 31 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 13 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission procedures ensure that the potential service user and the home have enough information to make an informed decision about whether the placement will be suitable. Evidence: There have been no recent admissions to the home and none are planned. The policies and procedures for admission take into account individual needs and would allow a getting to know you period which was as long as the person needed to be sure that they would settle in their new home. All of the necessary information about the potential service user is gathered by the home. When the last admission was made we commented that service users and staff do everything possible to ensure that individuals feel welcome. The service user guide and statement of purpose are being updated. The information that we saw during the inspection was accessible to service users and we are assured that these documents will be similarly written. An example is the service user contract which is written in plain English with pictures to assist reader to understand the document. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: Care Homes for Adults (18-65 years) Page 15 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from a care planning system which is person centred and in which they are fully involved. There are good opportunities to be involved in decision making about their daily lives and the way in which the home runs. Evidence: We met all of the service users when we visited the home. They told us that they are included in decision making and make choices about their lives. A person centred care planning system is used. The system is being reviewed by the Frances Taylor Foundation and one of the service users from this home has been a member of the working party conducting the review. The care plans which we saw were clear, written in plain English and had pictures and photographs to illustrate the text. They include the service users goals for the future, one plan that we saw broke down the skills that the service user would need to learn to achieve a particular goal. This, along with the three monthly reviews of goals with key workers, assists the service user in plotting her progress towards the goal. Service users are also involved in the risk assessments and the exercise is aimed at supporting them to Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: carry out activities which may involve risks in a planned and careful way. The service users keep their care plans in their rooms and decide who may see the documents. There are appropriate facilities to store information confidentially. As well as involvement in care planning the service users have the opportunity to make decisions about the way their day to day lives through the service user meetings which held. On a Sunday the service users plan the menu together. The minutes of the meeting use pictures and plain English to make sure that they are easily understood by service users. Care Homes for Adults (18-65 years) Page 17 of 31 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 users make choices about how they wish to spend their time and are supported to lead interesting lives and develop a range of skills. Evidence: Surveys were completed by service users before we visited the home. They told us They can choose what to do and where to go. When we spoke to a group of service users they told us about their activities and said tjhat they enjoyed them. The service users have the opportunity to follow activities which interest them in the local community. All of the service users take part in an activity outside the home at least twice a week. Some of the service users are following adult education courses, two people are on a catering course at Vauxhall College, others follow life skills courses at Brixton College. Five of the service users do voluntary work in the local area. Those service users who are able to travel independently do so, otherwise they are supported to their activities by staff members. If service users wish they go to Church, one member of the group chooses to do so. A relative who completed a survey said of her relative who Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: lives in the home she leads a full and active life and always appears to be very happy. All of the realtives who responded to our surveys said that the service users are supported to lead the life they choose. The service users have a variety of leisure activities that they follow, including social clubs, going to the cinema and concerts. They also meet their friends, some of whom live in other Frances Taylor Foundation services and visit family members. They welcome friends and family to visit them at Woodbourne Avenue. The staff assist the service users to make new friends and relationships. They provide any support necessary. On our visit we found the service users very welcoming, courteous and helpful. At home the service users watch television, listen to music, play games and take part in household activities. One service user said that she is pleased that the home allows me to spend quality time alone in my bedroom. The service users plan the weeks menu together on a Sunday, write a shopping list and take it in turns to accompany staff to buy the food. Local shops are visited by service users each day to buy fresh milk, bread and fruit and vegetables. All of the service users said that they like the meals in the home and are involved in preparing meals, setting the table and washing up. The menu takes into account individual needs, it uses photographs to present the choices available for breakfast and lunch. Care Homes for Adults (18-65 years) Page 19 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are satisfied with the support they receive which reflects their wishes and needs. Health care is good and provided in partnership with health care professionals. The are safe systems for managing medication. Evidence: The involvement of the service users in the care planning system means that the care matches their preferences and needs. The service users are all women, as is the staff team so same gender care can be offered at all times. The surveys from service users told us that the service users are happy with the care they receive, comments included staff are very caring and the carers look after me very well. One person said that when she is unwell the carers are attentive and reassuring. Each of the service users has a health action plan which is reviewed monthly. They are supported to attend health care check ups and in response to particular needs. We heard from a health care professional that staff give appropriate support to the service users and they are encouraged to express their own needs. All of the staff have had training in safe medication practice at Croydon College. We looked at the records and found that they were in very good order. There were no unexplained gaps; a list of homely remedies has been approved by the GP and Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: information about the medications is available to staff. Some medication is given on an as needed basis for epilepsy. The records showed careful monitoring of the condition and the use of the medication. We also learned of a referral to a specialist in response to the monitoring. The use of homely remedies is recorded in a book on which several service users records are on the same page. We recommend that a separate page is used for each service user in order to help maintain their confidentiality. It is an aim of the home to assist service users to look after their own medication if they wish, and are assessed as able, to do so. The Registered Manager acknowledges that this will be a slow process and will need to be achieved slowly and carefully with the agreement of medical professionals. Care Homes for Adults (18-65 years) Page 21 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are protected by the complaints and safeguarding procedures. They have benefited from workshops aimed at raising their awareness of the action to take when they may be unsafe. Evidence: The complaints procedure has been reviewed since our last visit to the home. It is written in plain English and has pictures and photographs to explain the text all of which make the procedure very clear and appropriate for the service users. The procedure gives options for how a complainant may complain, who to, and gives a list of frequently asked questions. When this was discussed with service users they could suggest people they would talk to if they were unhappy with anything. Similarly relatives said that they also knew how to complain and staff were aware of the procedure to follow if a concern was raised with them. There have been no complaints received over the last year. There has been one safeguarding issue which has been properly dealt with by the home and all necessary action was taken to ensure that the service users are kept safe. The home has been proactive in finding resources to empower service users to recognise and get assistance with risky situations. They have held workshops with service users which include a DVD to assist service users to use whistle blowing procedures. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: The Registered Manager is aware of her responsibilities under deprivation of liberty safeguarding legistlation and assessments have been carried out for all of the service users. Care Homes for Adults (18-65 years) Page 23 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and homely, clean and safe. Evidence: The home is situated in a residential street between Streatham High Road and Tooting Bec Common and is indistinguishable as a care home. The house is very homely and comfortable. All of the feedback we received about the building commented on how clean it is. We were also impressed at the standard of cleanliness. The communal areas are a good size and allow the service users to sit together for joint activities. Each of the service users has a single bedrooms, we saw a selection of rooms and saw that they are personalised and comfortable. Service users are happy with their rooms. None of the rooms have en-suite facilities but they are fitted with handbasins and are close to the WCs and bath rooms. There is an attractive garden to the rear of the home. Security lights are fitted to the exterior of the building to ensure the safety of service users and staff. Care Homes for Adults (18-65 years) Page 24 of 31 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. There are enough well trained and supported staff to provide care for the service users. Evidence: The staff team consists of, in addition to the Registered Manager, a Deputy Manager and five support workers, (two of whom work part time). In addition to the permanent staff the home can draw on a pool of Bank staff who are employed on a permanent basis at other homes run by the Frances Taylor Foundation. This means that agency staff do not have to be used and gives consistency of care. The usual staffing levels are three staff on duty in the early shift (7 or 8am to 3 or 4pm), and two staff on duty from 1 or 2pm until 9pm. Overnight there is one member of staff sleeping in the building. These numbers are adequate for the numbers of service users and their needs. All of the care staff have achieved NVQ2 or above. In addition they undertake training which is appropriate for the needs of the service users who live in the home. Over the past year this has included epilepsy awareness; the Mental Capacity Act; dementia care and challenging behaviour. Staff feedback was that the training was appropriate for their work and helped them to do their jobs well. Responses to the question what does the home do well included provide regular training for staff that is relevant to their job role and offer up to date training... enabling staff to maintain their skills and knowledge. We heard from staff that the team works well together and that there are effective Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: systems for communication between them. Regular staff meetings are held and service user issues and matters of general concern are discussed. Staff said that they feel well supported, they receive formal supervision and can approach managers between the sessions to discuss matters. The recruitment records that were examined were in good order; appropriate checks had been taken up and there is a six month probationary period before the person is confirmed in post. This assists in the protection of service users. Service users are involved in the recruitment process. Care Homes for Adults (18-65 years) Page 26 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management systems work well and the home is managed in the best interests of the service users. The service users and others concerned with their welfare have the opportunity to contribute their views about the service. Regular checks make sure that the home is a safe place to live and work. Evidence: The Registered Manager has been in post since 2006 and is experienced and qualified for the role. The feedback that we received from a variety of sources is that she encourages an open atmosphere and service users concerns are given priority. Comments included the home is managed to a very high standard and I feel this home is run exceptionally well. There are a number of quality assurance systems in place at the home. The views of service users, relatives and staff are sought through surveys. In order to ensure impartiality service users and staff from other services assist the service users to complete the survey forms. A new survey was planned to take place soon after our visit. Monthly visits to the home are made as required by Regulation 26 of the Care Homes Regulations. The reports that we saw showed that the visits include monitoring the Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: homes records, viewing the premises and discussion with service users and staff. We checked a sample of service users financial records. We found that they were in good order, the service user signs the record, and this verifies her involvement. The record showed that money is spent on appropriate items and the record tallied with the receipts on file. Access to finances is limited to senior staff. Health and safety checks take place at appropriate intervals. There is a weekly exercise to spot hazards in the building, fire alarm systems are checked and drills are conducted. The most recent one was in October 2009. The fire risk assessment was reviewed in June 2009. There was a full health and safety audit of the home in November 2009. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 19 We recommend that each service users use of homely remedies is recorded on a separate page. This will help to maintain the service users confidentiality. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2010) Care Quality Commission (CQC). 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