Inspection on 17/12/08 for Elmfield Way, 1-2

This is the latest available inspection report for this service, carried out on 17th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elmfield Way, 1-2 21/08/07

Elmfield Way, 1-2 18/12/06

Elmfield Way, 1-2 01/02/06

Elmfield Way, 1-2 03/03/05

Elmfield Way, 1-2 13/10/04

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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 27/02/2009.

CARE HOME ADULTS 18-65 Elmfield Way, 1-2 1-2 Elmfield Way London W9 3TU Lead Inspector Simon Smith Key Unannounced Inspection 17th December 2008 11:45 Elmfield Way, 1-2 DS0000010873.V364526.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 Elmfield Way, 1-2 DS0000010873.V364526.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. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmfield Way, 1-2 Address 1-2 Elmfield Way London W9 3TU 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 7266 1200 020 7266 3412 info@yarrowhousing.org.uk Yarrow Housing Limited Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Elmfield Way, 1-2 DS0000010873.V364526.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: 6 29th January 2008 Date of last inspection Brief Description of the Service: 1-2 Elmfield Way is a registered care home providing accommodation and personal care for six people with autism and/or challenging behaviours. Kensington Housing Trust owns the property and the care is provided by Yarrow Housing Limited, a voluntary organisation. The home is located off Harrow Road, close to local shops and transport links. Originally built as two separate units, the home has been converted to provide spacious accommodation that is fully accessible to people using wheelchairs. The home is well staffed to provide intensive support to people with high care needs. Elmfield Way, 1-2 DS0000010873.V364526.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. We used evidence from several sources to make this judgement about the home. These included visiting the home unannounced and speaking to residents, the deputy manager and staff. We also looked at some written records, including staff records and residents’ care plans. The home met 27 of 31 National Minimum Standards assessed at this inspection. One standard was exceeded and three standards were almost met. What the service does well: What has improved since the last inspection? What they could do better: Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 6 Address the issues regarding the management of the home. Ensure that the home has a permanent manager who is registered with the CSCI. Carry out the work recommended by the heating engineer at his last visit. Clean the kitchen extractor fan more regularly. Please contact the provider for advice of actions taken in response to this 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. Elmfield Way, 1-2 DS0000010873.V364526.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 Elmfield Way, 1-2 DS0000010873.V364526.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): Standards 1, 2, 4 and 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed before they move to the home. People thinking of moving to the home are able to make trial visits before they decide to move in. People living at the home had good support to make an informed choice about whether to move in. There is a Service User Guide, which outlines how people living at the home will be supported. Residents have an agreement with Yarrow Housing that sets out the terms of their accommodation. EVIDENCE: Residents have a thorough assessment before they move to the home to ensure that the service can meet their needs. The assessment addresses healthcare, cultural and religious needs, staff support and day service needs Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 9 and identifies any healthcare professionals that need to be involved in residents’ care. There was evidence that people thinking of moving to the home are able to make trial visits, including overnight stays, before they decide to move in. Residents’ files demonstrated that they had been given excellent support to make an informed choice about where to live, for example engaging an independent advocate to support the resident’s decision making. The home has produced a Service User Guide, which outlines how people living at the home will be supported. Each resident has an agreement with Yarrow Housing for their accommodation, which have been personalised by the home. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 10 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): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are person-centred and involve residents and other relevant people in their development. Residents get good support to make decisions about their lives. Risk assessments are clear and regularly reviewed. EVIDENCE: The inspector looked at some residents’ care plans. These contained good, individualised information about residents’ strengths and needs. Care plans also identified important people in residents’ lives and contained good information about individual preferences in terms of daily living. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 11 Residents get good support to make decisions about their lives. Staff have enabled residents to draw up Circles of Support, which involve all relevant people in co-ordinating the care and support residents receive. The Circle of Support groups meet regularly to review the support the resident receives. Staff also promote residents’ choices in their daily lives. For example residents at home during the inspection were able to choose which member of staff supported them. The home carries out risk assessments to enable residents to take risks as part of an independent lifestyle, for example when accessing the community or using public transport. The risk assessments on file had been regularly reviewed and updated. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a range of activities that reflects their needs and interests. Residents have active social lives and are involved in their local community. Residents receive good support to maintain relationships with their families. Residents’ rights and responsibilities are promoted in their daily lives. The home’s menu is varied and designed to meet residents’ needs. EVIDENCE: Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 13 Staff said that residents are encouraged to involve themselves in the routines of the home and to take on responsibilities in areas such as personal laundry and housework. Residents are actively involved in their local community, making use of shops, pubs, cinemas, restaurants and other resources, and staff said that trips to places of interest are often arranged at weekends. The deputy manager said that the local authority’s Flexible Response Service provides a wide range of opportunities based on residents’ needs and interests. The deputy manager said that the Flexible Response Service had supported residents to try new activities including aromatherapy, swimming, bowling and sensory sessions. Staff said that all residents have some contact with their families and that residents are supported to make visits to their families. One resident stays with his family on alternate weekends. As highlighted in the previous section of this report, families are also encouraged to attend Circle of Support review meetings. Residents’ rights and responsibilities are promoted in their daily lives. Interaction between staff and residents was positive during the inspection and staff addressed residents with respect. Residents are able to choose how they spend their time at the home and to have privacy when they want it. Staff gave examples of how the home has addressed residents’ cultural needs, such as supporting people to attend religious services, celebrate festivals and eat particular foods. The menu indicated that the home provides a varied and well-balanced diet. Staff said that they aim to support residents in making informed choices about their diet and to promote healthy eating. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 14 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): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive consistent care in the way they prefer. Residents have access to appropriate health care and treatment when they need it. The home works well with other professionals in making sure residents receive good care. Medication is stored and administered safely. EVIDENCE: Staff on duty had a good knowledge of residents needs. There is good guidance for staff in their work to make sure that residents receive consistent care in the way they prefer. One resident exhibits behaviour that challenges the service. A senior challenging needs nurse has worked with the staff team in developing guidelines to manage the behaviour. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 15 There was evidence that the home seeks the advice of appropriate healthcare professionals where necessary about residents’ care. For example the home liaises closely with the local community learning disabilities team and thus has access to community nursing and psychology services. There was also evidence that residents with ongoing conditions such as epilepsy have access to appropriate care and regular monitoring by specialist professionals. Medication was stored appropriately at the time of inspection and there are written procedures governing the administration of medication. Staff who administer medication attend training before they are authorised to do so. All medication coming into or leaving the home is recorded. Medication records were checked and found to be accurate. The home has improved the recording of ‘As Required’ medication since the last inspection. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 16 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): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place for the management of complaints. Complaints receive an appropriate response. Staff attend training in the recognition, prevention and reporting of abuse. EVIDENCE: Yarrow Housing has an appropriate complaints policy, which is available at the home. There is also a Whistle-blowing procedure, which enables staff to report any concerns about they have about poor practice. There have been two complaints about the home since the last inspection. The complaints book demonstrated that these complaints received an appropriate response. The home works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’, which provides guidance for staff in the recognition and reporting of abuse. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 17 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): Standards 24, 25, 27, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, safe and well maintained. Residents’ bedrooms reflect individual tastes and interests. The home is clean and hygienic but the kitchen extractor fan needed cleaning. Some parts of the home have been improved since the last inspection and further improvements are planned. EVIDENCE: Elmfield Way is a purpose built, single storey home that provides spacious, wheelchair accessible accommodation. There is a well maintained garden, which has a summerhouse. The home is located off Harrow Road, close to local shops and transport links. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 18 All parts of the home had been repainted since the last inspection and the floor coverings had been replaced. Staff said that residents were consulted about the colour schemes used in the redecoration. The communal rooms include a large living/dining area, quiet lounge and kitchen. A contractor visited on the day of inspection to supply an estimate for fitting new flooring and units in the kitchen. The home has two bathrooms with bath and shower facilities and four toilets. All residents have a single room with basin and direct access to the garden. Residents’ bedrooms are personalised and contained evidence of individual hobbies and interests. All parts of the home were clean and hygienic at the time of inspection but the kitchen extractor fan needed cleaning. See Requirement 1. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 19 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): Standards 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a stable staff team. Staff know residents’ needs well. Staff are appointed following an appropriate recruitment and selection procedure. Staff have access to appropriate training and good support to do their jobs. EVIDENCE: Many staff have worked at the home for some time and know residents well. There are guidelines for staff in their work with residents to ensure that residents receive consistent care and support. The home employs sleep-in and waking night staff at night and has access to bank staff to cover vacant shifts. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 20 The inspector spoke to three staff during the inspection. All said that they received good support to do their jobs and regular supervision from their manager. Staff also said that they had good support from their colleagues and that the team communicates well. Staff files contained a pro forma that confirmed Yarrow had obtained Criminal Records Bureau Disclosure, two references and proof of identity before they started work. Staff said they had a thorough induction when they started work, which included shadowing an experienced member of staff, and had to complete a probationary period. Yarrow Housing provides appropriate training for staff, including support to complete National Vocational Qualifications. One member of staff said that she had completed the Learning Disability Qualification since she started work at the home and had now registered for NVQ level 2. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 21 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): Standards 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Yarrow Housing must ensure that the home has a permanent manager who is registered with the CSCI. Residents are consulted about issues that affect them. There is a commitment to running the home in residents’ best interests. The health and safety of residents and staff is maintained but the home must carry out the work recommended by the heating engineer at his last visit. EVIDENCE: Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 22 The home manager joined the home in June 2008 but had been away from the service for approximately six weeks at the time of inspection. The management of the home was being covered by two experienced deputy managers and staff said that the care services manager visits regularly to support the service. However Yarrow Housing must ensure that the home has a permanent manager who is registered with the CSCI. See Requirement 2. The inspection provided evidence that residents are consulted about issues that affect them in their daily lives, such as how the home is decorated and how they spend their time. Where residents need support to make important decisions, there was evidence that the home had arranged ‘best interest’ meetings, which were attended by family members and relevant healthcare professionals where necessary. Yarrow Housing distributes a questionnaire to residents’ next of kin to ask their opinions on the care and support provided to residents. Yarrow managers also visit the home each month to monitor the quality of the service. Staff check the fire alarm system weekly using different call points. The fire alarm test certificate was issued by an engineer in September 2008. A fire risk assessment of the building has been carried out. There is a written fire procedure and regular fire training for staff. The home has current Employers Liability Insurance. The landlord’s gas safety record was issued in June 2008. The accompanying report states that a flue guard should be fitted to the boiler but this work had yet to be carried out at the time of inspection. See Requirement 3. Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 X 4 4 5 3 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 3 25 3 26 X 27 3 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 2 X Elmfield Way, 1-2 DS0000010873.V364526.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 2 Standard YA30 YA37 Regulation 23(2) 8 Timescale for action The Registered Person ensure 30/01/09 that the kitchen extractor fan is cleaned. The Registered Person must 30/01/09 ensure that the home has a permanent manager who is registered with the CSCI. The Registered Person must 30/01/09 ensure that a flue guard is fitted to the boiler. Requirement 2 YA42 13(4) 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 YA20 Good Practice Recommendations Arrange annual checks of medication with the home’s supplying pharmacist. Elmfield Way, 1-2 DS0000010873.V364526.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 Elmfield Way, 1-2 DS0000010873.V364526.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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