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Inspection on 28/06/09 for Martindale Road, 329

Also see our care home review for Martindale Road, 329 for more information

This is the latest available inspection report for this service, carried out on 28th 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is spacious and well equipped to meet the needs of people with a physical disability. The home provides information to people who use the service in a format that is suitable with plain English and pictures. A full schedule of activities is organized and a designated member of staff is available for this. There are three staff on duty for seven people and staff receive regular mandatory training. The Registered Manager has provided clear information in the Annual Quality Assurance Assessment and is looking at ways to improve the service. People have a care plan and person centered plan and the staff team are working towards changing the presentation of these to suit the people who use the service.

What has improved since the last inspection?

The presentation of information to people has improved. The environment has improved with some recent decoration to the communal areas.

What the care home could do better:

The information sought prior to a people moving into Martindale Road needs to be improved.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Martindale Road, 329 Martindale Road, 329 Hounslow Middlesex TW4 7HG     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: Susan Woolnough-Singh     Date: 0 7 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Martindale Road, 329 Martindale Road, 329 Hounslow Middlesex TW4 7HG 02085776031 Telephone number: Fax number: Email address: Provider web address: martindaleroad@lot-uk.org.uk lifeopportunitiestrust.co.ukwww.lifeopportunitie str Name of registered provider(s): Type of registration: Number of places registered: Life Opportunities Trust care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 7 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: Learning disability - Code LD Date of last inspection Brief description of the care home 329 Martindale Road, Hounslow is a purpose built seven place care home for adults with learning disabilities. Although a two storey property, the service users are all accommodated on the ground floor. Only the office is upstairs. Communal rooms are of a good size and there is a large and secure garden to the rear. All downstairs areas have level access and are accessible to people in wheelchairs. The locality is a residential area near a bus route to Hounslow town centre. Life Opportunities Trust Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 7 Brief description of the care home (LOT), who operate the home, is a not for profit organisation. The current fees charged for a place at the care home are #1,308.60 per week. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was a key inspection that considered mainly those standards that are the key standards within the National Minimum Standards (NMS) for care homes for younger adults, as published by the Department of Health. The Registered Manager of the care home completed in advance of the inspection a detailed Annual Quality Assurance Assessment (AQAA). We visited the home unannounced on a Sunday and spent over 3 hours at the home during which time we met staff and residents, toured the premises, and examined a range of records. disability are appropriately addressed by the management of the home. All the requirements except one from the previous CSCI inspection have been met. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information provided by the home has been improved for people and is in a pictorial format. Up to date information on peoples care needs must be sought prior to people moving into the home. Evidence: The home has informed us that the Statement of Purpose and Service Users Guide are in pictorial form and the home is working towards improving information for people by using pictures as a form of communication. One new person had moved in to the home a few days prior to the inspection. This person had been transferred from another Life Opportunities Trust home and we were able to see the care records forwarded by the other home. These consisted of a health action plan, basic information and minutes of a residents meeting. The information required for admission was not complete and the Registered Manager acknowledged Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: this. The information required was being held at L.O.T Head Office. The Registered Manager reported that people living in the home would be having reviews on 1st and 2nd June 2009. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a care plan that gives guidance on how their needs will be met and a person centered plan on their routines and preferences. Risks are assessed and duly recorded with guidance. People are able to take risks and make decisions depending on their individual level of ability. Evidence: We looked at the care records of two people who use the service. We were able to see care plans that contained information on the persons needs incorporating health, social care, diet and personal care. One person was able to provide his own personal care and this was documented in the care plan. People also have a Person Centered Plan this identifies peoples preferences for daily living, and social networks for family and fiends. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: We looked at the Risk Assessment file and were able to see that individual risk assessments were in place for people. These included activities such as going out into the community, mobility, personal care and fire risk. We requested information after the visit to the home and were informed that all people had their care reviewed on the 1st and 2nd June 2009. The Annual Quality Assurance Assessment told us that residents meetings take place whereby people are consulted and enabled to make choices. We met all the people who were at home during the inspection and were able to talk with one of them. She/he had only just moved in and spoke of the staff and an activity that had taken place the night before. We spoke with the staff group with regard to how people are enabled to make decisions. Staff are aware of peoples way of communicating which can be non verbal. People can be asked about choices and will respond accordingly for example, with gestures. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are offered a home based activity schedule which includes participation in the community. The home is aware of the preferences and dietary requirements of people who use the service. Evidence: The Annual Quality Assurance Assessment informs us that people regularly participate in activities in the community and that an Aromatherapist and a Music Therapist visit the home on a weekly basis. We spoke with one person who uses the service and she/he spoke about a social activity which had taken place the previous night organized for people who live in LOT homes, and that this had been an enjoyable event. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: We spoke with staff with regard to activities in the home. A designated Activity Leader works full time in the home. People had been to the Beck Theatre on the Thursday prior to the inspection and we were informed that this was popular venue for the home and shows were booked in advance. People visit other local venues, go out to the pub and on local walks. Usually two people at a time participate in activities but everybody has the opportunity. Activity cards are available in pictorial format for people who use the service. People do not attend a day service and the home is responsible for the weekly schedule. People have differing levels of contact with family and friends depending on their circumstances. We received a copy of three weeks menus and could see that a variety of food is on offer daily. We observed that a main meals was being cooked, we could see that fresh home cooked food was being prepared. People eat at a large table in the dining room. Information on dietary requirements, likes and dislikes is contained in the care plan. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in the way they prefer and require. Peoples physical and emotional health needs are documented. The homes medication records are well maintained. Evidence: Information on personal support and the health care needs of people is contained in the care plan and health action plan. We looked at the care plans and health action plans of two people who use the service. The information is set out in a clear and informative way. We noted that one health action plan needed to be reviewed. The Annual Quality Assurance Assessment states that the people are offered a range of health appointments. These include Community Nurses, District Nurses, Physiotherapist and Occupational Therapist. We examined a sample of the medication storage arrangements, and the medication Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: administration records. All were in good order. Medication is provided by a National Pharmacy and is ready for administration in a Monitored Dosage System. Medication procedures are in place and staff sign to verify that procedures have been read. The medication cabinet and contents were secure but the section for controlled drugs was broken. This needs to be repaired or replaced. No controlled drugs were being used at the time of the inspection. In response to the draft report the Registered Manager confirmed that controlled drugs were not being stored and the cabinet in question had been removed. We spoke with staff who confirmed that they had received training in medication administration. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures are in place to safeguard adults and offer guidance in protection to care staff. Evidence: The Annual Quality Assurance Assessment informed us that a Pictorial Complaint Procedure and Protection of Vulnerable Adults procedure is in place and that all staff have received training on safeguarding adults. Training takes place on an annual basis. One complaint was made to Care Quality Commission (formerly Commission for Social Care Inspection) during 2008. This was included in the Annual Service Review on 16th October 2008. Hounslow Social Services investigated the complaint the outcome of which was that a person was offered alternative accommodation as their needs could no longer be met at Martindale Road. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which is clean, safe and comfortable. Evidence: We toured the building and looked at the communal areas of the home and the bedrooms. We were informed after the field visit that decorating had taken place and the lounge, dining room and kitchen had been painted. The home is spacious and has the necessary equipment for people who have a physical disability. The bedrooms were adequately furnished and personalised for individual taste. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by the Life Opportunities Trust recruitment procedure. Staff receive Induction Training, Mandatory Training and training in National Vocational Qualifications. The number of staff on duty is sufficient to ensure that people can be cared for effectively. Evidence: The Annual Quality Assurance Assessment informed us that the staff team comprises of twelve full time staff and five part time staff. The staff team is ethnically diverse with twelve female staff and five male staff. We studied the staff rota for the period week commencing 21st June 2009. There is a minimum of three staff on duty during waking hours and two waking night staff. We did not sample recruitment records during this inspection as the Registered Manager was not on duty and records are kept confidentially and securely. We Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: requested that verification of recruitment be forwarded for staff particularly new members of staff. We received verification from Life Opportunities Trust of recruitment of two members of staff in the from of a scanned letter. One member of staff was recruited in 2009. There was a Criminal Records Bureau check reference number, confirmation of identity verification and a reminder fro the Registered Manager to see authorization papers to enable people to work in the United Kingdom. Confirmation was given that an application form and two references had been received. The Annual Quality Assurance Assessment informed us that LOT provide an Induction programme for new staff and opportunities to undertake National Vocational Training in Health and Social Care. The Registered Manager forwarded information on National Vocational Qualifications in response to the draft report. We were informed that six staff have N.V.Q Level 2, two staff have N.V.Q Level 2 and 3, one staff member has N.V.Q Level 3. Two staff are studying for Level 2 and one for Level 3. We looked at the staff training profile; staff had received training in moving and handling, food hygiene, first aid, fire safety and protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from a well run home. The National Minimum Standards have been reviewed as part of the Annual Quality Assurance Assessment and changes made as a result of consultation with people who use the service. The health, safety and welfare of people who use the service and staff are sufficiently promoted and protected Evidence: The Registered Manager has obtained the Registered Managers Award, National Vocational Qualification level 4 and is an NVQ Assessor. The Annual Quality Assurance Assessment has been completed to a good standard with examples of how minimum standards are being met and identifies areas for improvement. We were informed that annual surveys are sent out to people and their families and that changes have been made as a result of consulting people. These are, Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: activities and holidays, providing information in pictorial form, menu planning and having staff duty board with photographs. Policies and procedures are in place for health and safety. These cover infection control, fire safety, first aid and food safety. We sampled a number of health and safety records. Fire records were seen, fire drill evacuations had taken place in April. May and June, and fire call point testing, weekly, There was a fire risk assessment for the premises and according to information on the Annual Quality Assurance Assessment the fire alarm system had been serviced in 2009. We noted that the date for Gas Appliance servicing was 2007. In response to the draft report the Registered Manager informed us that a Gas service had taken place in August 2009 and a certificate for this had been issued. A premises risk assessment had taken place in 2008. Hoists and equipment had been serviced in April 2009. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 14 The Registered Provider and Registered Manager must ensure that a full assessment of peoples care needs is available prior to admission. A record of this must be kept at the home. The care staff at the home need relevant information of the needs of the person using the service. 01/09/2009 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 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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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