Inspection on 04/06/09 for 104 Tolworth Park Road

This is the latest available inspection report for this service, carried out on 4th June 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

104 Tolworth Park Road 30/08/05

104 Tolworth Park Road 26/01/05

104 Tolworth Park Road 10/01/05

104 Tolworth Park Road 22/06/04

104 Tolworth Park Road 24/10/03

Similar services:

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 104 Tolworth Park Road 104 Tolworth Park Road Surbiton Surrey KT6 7RH     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: 0 4 0 6 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 25 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 25 Information about the care home Name of care home: Address: 104 Tolworth Park Road 104 Tolworth Park Road Surbiton Surrey KT6 7RH 02082742747 02082742747 tolworth@regard.co.uk 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) : The Regard Partnership Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 A variation has been granted to allow one specified service user over the age of 65 to be accommodated. Date of last inspection Brief description of the care home 104 Tolworth Park Road is a residential care home for six adults with a learning disability, located in a residential area of Tolworth. Six people are currently living there. It is owned and managed by the Regard Partnership. Main shops and facilities are close by in Surbiton or Kingston and a local bus route runs near to the home. Information about the service is available in the Statement of Purpose and Service User Guide. Current fees range from £1,500 to £1,800 per week. Care Homes for Adults (18-65 years) Page 4 of 25 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 peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over seven hours on the 4th June 2009. One regulation inspector visited, spoke with people who use the service, staff and the manager and looked at records. Questionnaires were sent to relatives of people who use the service and placing social workers. We have received two completed questionnaires, information from these are included in this report. We received a completed Annual Quality Assurance Assessment (AQAA), this contained good information and evidence of how the service meets peoples needs which has been used throughout this report. Care Homes for Adults (18-65 years) Page 5 of 25 Care Homes for Adults (18-65 years) Page 6 of 25 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 7 of 25 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 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to good information about the service, to help them decide whether to move in. Peoples needs are assessed before they move in, ensuring the service is the right place for them and their needs will be met. Evidence: The manager told us they have information for new or prospective people about the services provided in a Statement of Purpose. We saw a Statement of Purpose and Service Users Guide which give good information about the services provided. The manager told us that they complete detailed assessments and develop an individual plan before anybody moves in. We saw assessments completed before people had moved in which are kept up to date. People told us they visited before they moved in. One person remembers the manager visiting at their previous place. Care Homes for Adults (18-65 years) Page 9 of 25 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. People who use the service develop their care plans with staff from assessments and incorporate goals they want to achieve. These documents are in written and pictorial format, making them accessible and real for people. Risk assessments are in place. Evidence: The manager told us that a new care planning format is in place, with better communication tools and pictorial and symbolic information, which focus on the individuals needs. We saw care plans to be detailed with the care, support and assistance the individual needs. This information is in written and pictorial format, making it accessible to people who use the service. People who use the service told us they meet with staff, staff know what I need and staff help. Case files are detailed and we saw them contain a pen portrait. These give information about the individual and their life history. These are complemented by a profile, which includes a photograph of the person. A list of likes and dislikes, Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: strengths and needs and a list of short, medium and long term goals are included. This gives staff a full picture of the individual, their needs and how they should be met. Information about the individuals religion and any cultural needs are noted so they can be met. The service operates a key work system, people were aware who their key workers are and see them daily or weekly and every month for a meeting. We saw risk assessments in place which are relevant to the individual and are reviewed and updated when required or every six months. Care Homes for Adults (18-65 years) Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service puts peoples rights and choice at the forefront and supports people to achieve their goals and live a full life. People have individual activity programmes to meet their social and leisure needs and are supported to be independent and involved in all areas of daily living in the home. Evidence: The manager told us people are very involved in making choices and expressing their preferences about how thier lives are run. People who use the service told us I go out, I do cooking at a centre and I do what I want. We saw people involved in doing the weekly shopping, watching television, talking with staff, listening to music, spending time in the garden, going out to classes and preparing to go to a club during our visit. Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: People told us they can have visitors and keep in touch with family and friends. The manager told us people who use the service are involved and supported to take part in the day to day running of the home. People confirmed that they go out shopping, hoover and dust their rooms and staff help them if required. A varied menu is provided which meets individuals needs and choices. One relative or friend said, in a survey they feel the diet is wholesome but seems deficient in vegetables and fruit. We saw the weekly shop to include fresh fruit and vegetables. We saw an evening meal be a social occasion for everyone, people sat together in the dining room or garden. Comments about the food provided included I like the food, I enjoyed dinner, its usually good and I like helping. The menu for the day is displayed in pictorial format so everyone knows what the meals are. This is a good initiative for the people who use the service. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive person centred personal and healthcare support to meet their individual needs. People have access to specialist and community healthcare services. Medication is well managed. Evidence: People told us staff listen, staff help and staff give me the help I need. We saw people offered support in a sensitive and respectful way. Peoples health needs are well recorded and met by staff. Every person has health objectives, approved by the GP, which are included in care plans and reviewed regularly. Medication is appropriately stored, records are up to date and signed by staff and medication had been administered as prescribed. The manager told us they are supporting people to self medicate, with appropriate risk assessments in place. People who use the service confirmed this. Care Homes for Adults (18-65 years) Page 14 of 25 Care Homes for Adults (18-65 years) Page 15 of 25 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 and accessible complaints procedure which is displayed at the home. Appropriate policies are in place and staff complete training on safeguarding. Evidence: We saw the complaints procedure displayed in pictorial format, accessible to everyone who uses the service and to visitors. People told us they would speak to staff or the manager if they had any worries or concerns. No issues were raised during our visit. The service has not received any complaints in the last year. We have not received any complaints or concerns since the last inspection. The manager told us that they plan to invite local advocacy groups to the service to speak with individuals and the group, to give people who use the service more opportunity to make general comments about the service. They also plan to use role play to practice peoples rights. The manager told us staff have completed training in adult protection and safeguarding. Staff confirmed that they have completed this training. The manager was clear about her responsibilities and who to report issues to in the local authority. Care Homes for Adults (18-65 years) Page 16 of 25 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 provides a physical environment that is appropriate to the specific needs of the people who live there. The environment is well maintained and provides the aids and adaptations required by individuals. The home is a pleasant and safe place to live. Bedrooms are single and have been decorated and personalised to the individuals choice. There are sufficient bathrooms and toilets for the people who use the service, although they are in need of refurbishment. Staff do not have toilet and bathroom facilities. All areas of the home were clean and fresh. Evidence: Improvements have been made to the environment since the last inspection. The kitchen has been refurbished, one bedroom has been redecorated and three bedrooms have had new flooring fitted. Further work is required to bring the bathroom and toilet to a good standard for the people who live there. The manager told us that they have the money and had quotes for this work to be completed. Staff have a separate room in the garden which is an office and used at night for one member of staff to sleep in. This room does not have a toilet or washing facilities. Consideration should be given to providing these facilities for staff. Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: One person told us their room is the best thing about living at Tolworth Park, other people told us they have all they need, I like my room and Im comfy here. We saw one bedroom without a lampshade, one bedroom with a broken lampshade and one bedroom with a contantly dripping tap. These issues should be addressed to keep the home at a good standard for the people who live there. All areas of the home were clean and fresh. People told us they are involved in cleaning their rooms and that this is appropriate. Care Homes for Adults (18-65 years) Page 18 of 25 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. People receive good quality care from a well trained and supported staff team. Staff recruitment is in line with regulations. Evidence: We saw some good interactions between staff and people who use the service. People made positive comments about staff including staff listen, they help and staff listen and do as I ask. Relatives or friends of people who use the service made positive comments about the staff team, including staff are lovely, staff are kind and little in the way of staff turnover which is wonderful for the people who live there. We the the the saw two members of staff on duty during the day, in addition, the manager is at home on weekdays. One member of staff is awake and one asleep but on call at home at night. These staff levels were seen to be sufficient to meet the needs of people who use the service. Staff recruitment records are kept at the organisations head office and a recruitment checklist is in place at the home, with dates and details of checks completed before staff started work. The manager said they plan to involve people who use the service in staff recruitment in the future. Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: The manager told us staff have access to training. Staff confirmed that they get training to help them carry out their role. The manager told us staff receive regular support and supervision. Staff confirmed that they are supported to do their job and have regular supervision. Care Homes for Adults (18-65 years) Page 20 of 25 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 required qualifications and experience to run the home. She is aware of the organisations strategic and financial planning and works within them. The manager has a very clear understanding of the focus of the service and directs it to be led by the needs of the people who live there. The annual assessment contains clear information and plans to improve and develop the service. Quality assurance systems are in place, giving people who use the service the opportunity to comment about the care and support they receive. Health and safety is well managed. Evidence: The manager has been at the home since it opened in 2002. She has kept up to date with training and current good practice and has completed management training. People who use the service and staff said the manager is available and approachable. We saw the manager respecting the needs and wishes of people who use the service and empowering people to make their own decisions. People who use the service have the opportunity to comment about the care and Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: support they receive and take part in the day to day running of the home. The organisation completes an annual survey, monthly visits take place which include talking with the people who use the service. The results of the annual survey are displayed on the noticeboard which is accessible to people who use the service and their representatives. Appropriate health and safety policies and procedures are in place. Checks are made of electrical and fire safety equipment at the required times. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 1 27 23 The bathroom and toilet must be refurbished. To bring thehome to a good standard for the people who live there. 26/03/2010 2 24 23 The redecoration schedule must be completed. To bring the home to a good standard for the people who live there. 29/01/2010 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 27 Consideration should be given to providing staff with toilet and washing facilities in the staff office/sleep in room. Care Homes for Adults (18-65 years) Page 24 of 25 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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