Inspection on 06/08/09 for Warwick Road, 17

This is the latest available inspection report for this service, carried out on 6th August 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Warwick Road, 17 11/05/06

Warwick Road, 17 29/11/05

Warwick Road, 17 13/06/05

Warwick Road, 17 25/10/04

Warwick Road, 17 04/08/04

Warwick Road, 17 06/01/04

Warwick Road, 17 04/06/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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: Warwick Road, 17 Warwick Road, 17 Ealing London W5 3XH 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: Jean Bovell Date: 0 6 0 8 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. 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 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) 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 29 Information about the care home Name of care home: Address: Warwick Road, 17 Warwick Road, 17 Ealing London W5 3XH 02088403109 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) : HM17Warwick@ealing.org.uk www.supportforliving.org.uk Support for Living care home 8 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 - 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 Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home The home is registered for eight service users with learning disabilities, including those over 65. There are currently four female and three male service users. The home is situated in a quiet residential area of central Ealing and is within walking distance of Ealing Broadway?s shops, facilities and public transport links. Notting Hill Housing Trust owns the premises. Ealing Consortium Ltd, a voluntary organisation, provides the care. The house is semi-detached, and has three floors, with two mezzanine floors. There is no lift and service users require good mobility to access all but the ground floor. The home has eight single bedrooms and the bedroom on the ground floor is en suite with its own shower. There are three additional bathrooms. The ground floor is wheelchair accessible and has a lounge, a kitchen with a dining area, and a laundry room. A stair lift onto the first floor is in place. There is a small lounge on the top floor which is used as the smoking area. The sleeping-in room is on the first floor and the top floor has an office with staff toilet and shower. There is a large rear garden, with seating, which has ramped access from the kitchen. A parking area is available at the end of the garden. The staff team consists of the Registered Manager, one senior support worker and six support workers. There are usually two care staff on duty on each shift, and one member of staff sleeps in at night. A variety of day facilities are accessed by the service users including college courses in Ealing and Acton. Care Homes for Adults (18-65 years) Page 5 of 29 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 Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home This unannounced inspection was carried out between 12 noon and 5pm on 10th August 2009. The Manager Designate, two support workers and six residents were at the house. We were informed by a support worker that one resident was at the day centre and another was independently involved in an activity within the community. During the course of the inspection: records, documents, policies and procedures in relation to key Standards were examined. A tour of the building was undertaken and observations were made. Discussions were held with the Manager Designate and four support workers. Eight residents were spoken with. A completed annual quality assurance assessment document (AQAA) was considered. All key Standards were examined. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well A service to people who have different cultural and religious needs. People who use the service receive opportunities for achieving individual aspirations. They are able to make decisions about their lives and in relation to shared activity within the home. Those with capacity are independent within the community. Contact between residents and their respective relatives and/or friends are encouraged and facilitated. Contact arrangements are initiated by support staff, where necessary, and particular residents are escorted to and from visits to relatives homes. The health needs of residents are being met as required and includes routine health checks. Medication procedures are accurately followed. All records including health and safety checks are maintained. Policies and procedures have been updated. Notifications are submitted to the Commission where appropriate. Regular training and refreshers for meeting the needs of the majority of people who use the service are being provided to care staff. Support workers were observed being attentive in their role and related in a friendly and respectful manner with residents. Care Homes for Adults (18-65 years) Page 8 of 29 People who use the service appeared appropriately dressed and healthy. Overall, the house was clean, hygienic and adequately maintained. The envirmonment was bright, airy and essentially homely. What has got better from the last inspection What the care home could do better The home must ensure capacity to meet the assessed needs of all prospective residents as stipulated under categories and conditions of registration, prior to admission. A pleasant and calm environment in which the emotional wellbeing of individuals is being protected must be maintained. Staff recruitment files must be available for viewing at key inspections. Care Homes for Adults (18-65 years) Page 9 of 29 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 Jean Bovell 33 Greycoat Street London SW1P 2QF 02079792000 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 10 of 29 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 11 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although initial needs led assessments are undertaken comprehensively, the homes capacity to meet individual identified needs is not all times accurately determined. Evidence: The personal files regarding five residents were viewed at random. Each file contained an initial written comprehensive needs led assessment undertaken by the service prior to admission. The assessed needs of one resident did not, however, fall within the homes categories and conditions of registration. As a consequence, an individual does not have compatibility with others living at the home and despite the involvement of appropriate health professionals, care staff are not suitably skilled and/or experienced to respond competently to related presented challenges within the home. Care Homes for Adults (18-65 years) Page 12 of 29 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. Care plans and risk assessments are being appropriately undertaken. Residents are able to make decisions regarding daily living routines. Evidence: Care plans were viewed at random and reflected that the changing needs of individuals were being assessed and action plans and set goals were put into place. Risk assessments had been undertaken in relation to specific activities identified within care plans. These included: moving and handling, wheelchair use, sexual vulnerability and using public transport. Care plans and risk assessments viewed were reviewed on a six monthly basis. There was recorded evidence that menus, shopping lists and shared activities were among issues discussed and decided upon by residents during weekly residents meetings. We were informed by a support worker that individual decisions made included Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: clothing worn each day, separate activities, make-up, hairstyles and personal purchases. Residents were also able to choose colour schemes for decorating their bedrooms. People were observed moving freely around the house and garden and separate interests and choices were reflected in personalised bedrooms. Care Homes for Adults (18-65 years) Page 14 of 29 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. Individual aspirations and social, cultural and religious needs are being met at the home. People are able to participate in activities in the local community and contact with relatives and/friends are encouraged and facilitated. Residents undertake appropriate housekeeping tasks. Varied and nutritious meals are provided. Evidence: Individual aspirations and social, cultural and religious needs were identified within care plans. There were indicators that residents attended Christian Church Services and/or visited the Mosque. They attended day resource centres and were enrolled on college courses in subjects such as computering, cooking, money skills and cooking. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Residents with capacity were independent in the local community. Others were supported in separate outdoor activities and shared activities were alsoo organised. The records indicated that individual and/or shared activities included shopping, bowling, horse-riding, football and cultural dancing. During the course of the inspection: residents were seen walking around the garden, viewing TV in the lounge and listening to music, reading or resting in separate bedrooms. Others sat and drank tea around the dining room table. An open visiting policy is in operation and contact with residents and respective relatives are encouraged and facilitated. We were informed by a support worker that contact arrangements were often initiated by care staff and if required, residents would be escorted to and from visits to relatives homes. Support workers confirmed that residents carried out housekeeping tasks such as setting the dining table, preparing vegetables and loading the dishwasher. Wholesome and varied cooked including cultural options were reflected on menus. Snacks and drinks were readily available and residents were observed making tea for themselves and others. A nutritious snack lunch was provided to residents at the time of the inspection. People who use the service appeared healthy and well nourished. Those spoken with reported being happy with the quantity and quality of food they received. Care Homes for Adults (18-65 years) Page 16 of 29 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. Individual personal and health needs are met as required but residents emotional needs are not being appropriately met. Medication procedures are fully followed. Evidence: The personal needs of residents were identified within individual support plans. It was indicated that some residents were self-caring and others required assistance or prompting. However, everyone chose what they wore each day, hairstyles and makeup. There was recorded evidence that the changing physical, emotional and mental health needs of residents were being assessed and they received access to appropriate health professionals when required. Residents were accompanied by support staff to medical appointments and routine men/women health checks were arranged. There were recorded indicators, that behavioural challenges presented by an individual impacted negatively on the emotional wellbeing of others. An individual was observed being emotionally upset following an incident involving another resident. Care staff were not fully competent in managing the situation and Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: the Manager Designate was asked to intervene. We were informed by the Manager Designate that a particular resident presented frequent challenges and required additional attention. A support worker confirmed that long standing residents resented the current situation. An individual reported being unable to settle at the home and expressed the desire to be placed elsewhere. It was evident that there was a degree of tension within an environment which was previously calm and pleasant. Procedures on medication were in place. It was evidenced that all medicines were safely and appropriately stored. Medication administration sheets were accurately documented and signed. Reviews of prescribed medications were being requested by care staff and undertaken GPs. There was documented evidence that medication audits were carried out by Boots Pharmacists on a three monthly basis. The records indicated that training on medication was delivered to all care staff. Care Homes for Adults (18-65 years) Page 18 of 29 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 complaints procedure is appropriately detailed. People who use the service are being adequately protected from abuse. Evidence: The complaints procedure is appropriately detailed and written/illustrated in a format suitable for meeting the needs of people who use the service. Accident and incident records are being maintained and notifications are submitted to the Commission where required. The Commission has been informed of various abuse allegations made by an individual against other residents and named care staff. All allegations were fully investigated and resolved with participation from appropriate health professionals. Due, however, to the repeated pattern of allegations, decisive appropriate action is necessary for safeguarding the emotional welfare of all the people who use the service. The Manager Designate confirmed that people who use the service received state benefits which were paid into separate bank accounts and personal cash allowances were held in safekeeping by care staff at the home. The separate financial records of five residents were inspected at random and were essentially satisfactory. Nonetheless, unclear alterations made to figures in relation to income and outgoing expenditure, and minor inaccurate calculations were identified within one set of records. These issues were discussed with the Registered Manager Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: and we were assured that appropriate action would be taken. Policies and procedures on the Protection of Vulnerable Adults were in place and appropriately detailed. The records indicated that care staff received refresher training on Safeguarding Vulnerable Adults in April, June and July 2009. Care Homes for Adults (18-65 years) Page 20 of 29 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 is adequately maintained. The environment is essentially homely. Evidence: The premises are adequately spacious, suitably furnished and appropriate for shared and/or individual activity. The garden was being maintained. No issues were identified regarding the laundry. Overall, the premises were clean, hygienic, bright, airy and reasonably well maintained. Despite an element of tension and un-ease, the environment was essentially homely. Care Homes for Adults (18-65 years) Page 21 of 29 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. Training and refreshers appropriate for meeting the needs of the majority of residents are being delivered to care staff. Staffing levels are adequate. Recruitment files were not accessible for viewing at the time of the inspection. Evidence: Staff rotas were indicative of two care staff being on duty during waking hours and one sleep over at night. Staffing levels at the time of the inspection were adequate for meeting the needs of people who use the service. We were informed by the Manager Designate that two members of the care support staff team achieved NVQ level 2 and three were receiving NVQ training. Training records were viewed. It was reflected that support workers received induction training and subsequent appropriate staff training and refreshers were being regularly delivered. Support workers who covered duty during the course of the inspection were observed being attentive in their role. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Staff recruitment files were not available for viewing at the time of the inspection. Care Homes for Adults (18-65 years) Page 23 of 29 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 Designate is suitably experienced and qualified. Annual quality assurance has been undertaken effectively. The health, safety and welfare of people who use the service are being protected. Evidence: The Manager Designate has been in post since 22nd June 2009. He has had seven years experience in the care field including twelve months as a Deputy Manager. The Manager Designate confirmed that he had achieved NVQ level 3 in Health and Social care and will very soon enroll for NVQ4 training. Support staff spoken with reported that the Manager Designate had good ideas and was in the process of re-organising and updating existing systems. An annual quality assurance assessment document (AQAA) was completed and returned to the Care Quality Commission. It was clear and provided all required information. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: Health and safety records such as fire safety checks, portable appliances tests and gas maintenance, were up-to-date. Fire drills were undertaken on a three monthly basis and appropriately recorded. Environmental risk assessments had been carried out. Training records were reflective of staff trainining and refreshers being delivered on Health and Safety, Fire Safety, Food Hygiene, First Aid and Moving and Handling. Policies and procedures on Health and Safety were comprehensive. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 1 2 14 The Registered Person must 31/10/2009 determine the capacity of the home to meet the assessed needs of all prospective residents prior to admission. This is to ensure that the needs of all residents are being competently met. 2 19 13 The Registered Person must make sure that effective measures for protecting the welfare of residents are in place. 30/09/2009 This is to ensure that the needs of residents are met as required. 3 34 19 The Registered Person must make sure that recruitment files are accessible to the Regulatory Inspector during 20/09/2009 Care Homes for Adults (18-65 years) Page 27 of 29 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 key inspections. This is to ensure that all documents under Schedule 2 of the Care Standards Regulations have been obtained. 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 28 of 29 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). 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. Care Homes for Adults (18-65 years) Page 29 of 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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