Inspection on 21/06/07 for 104 Tolworth Park Road

This inspection was carried out on 21st June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

104 Tolworth Park Road 30/08/05

104 Tolworth Park Road 26/01/05

104 Tolworth Park Road 10/01/05

104 Tolworth Park Road 22/06/04

104 Tolworth Park Road 24/10/03

Similar services:

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 09/07/2008.

CARE HOME ADULTS 18-65 Tolworth Park Road, 104 104 Tolworth Park Road Surbiton Surrey KT6 7RH Lead Inspector Adrian Gordon Key Unannounced Inspection 21st June 2007 9:30am Tolworth Park Road, 104 DS0000029148.V343566.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 Tolworth Park Road, 104 DS0000029148.V343566.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. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tolworth Park Road, 104 Address 104 Tolworth Park Road Surbiton Surrey KT6 7RH 020 8274 2747 020 8274 2747 tolworth@regard.co.uk 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) The Regard Partnership Limited Ms Catherine Juliet Condry Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow one specified service user over the age of 65 to be accommodated. 30th August 2005 Date of last inspection Brief Description of the Service: 104 Tolworth Park Road is a residential care home for six adults with a learning disability, located in a residential area of Tolworth. It is owned and managed by the Regard Partnership. Main shops and facilities are close by in Surbiton or Kingston and a local bus route runs near to the home. Information about the service is available in the Statement of Purpose and Service User Guide. Current fees range from £1600 to £1750 per week. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over the course of one day by one inspector. The inspection consisted of a tour of the premises, examination of records and observation of care practice. The inspector met all the residents, five members of staff and the manager. Feedback questionnaires were received from three relatives of people who live at the home. What the service does well: What has improved since the last inspection? What they could do better: The communal space at Tolworth Park is relatively limited for the number of residents. Although this is difficult to change, it would benefit residents if the delayed redecoration to certain areas of the home is now carried out. In particular the kitchen must be refurbished as planned. The unwanted equipment must also be removed from the garden in order to make it a safer area for residents. To make sure that residents know they are being listened to, the organisation must ensure that the results of any surveys are fed back to them in away they can understand. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 6 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. Tolworth Park Road, 104 DS0000029148.V343566.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 Tolworth Park Road, 104 DS0000029148.V343566.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): 1, 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have their needs assessed to make sure they home can offer a suitable placement. EVIDENCE: There have been no new admissions over the last year. Residents confirmed that they were able to visit before moving in. One person who lives there would like to move to a supported living service and the staff and manager are working with them to assess whether this is achievable. Needs assessments are put in place before people come to the home so that staff know what support to give. These are reviewed regularly and were seen to be up to date. Contracts are given to all residents. These are in an easy to read format and explain what the fees are for, together with rights and responsibilities while living there. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 9 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): 6, 7, 8, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care plan system is focussed on the individual and ensures that residents needs are met and regularly reviewed. EVIDENCE: Each resident has a ‘pen portrait’ in their file which gives a positively written description of who they are. Support plans hold a lot of useful information about how to help each resident and are based on individual needs such as washing hair, using the telephone, cooking and personal care. A life plan was seen for one resident which was written from their point of view using symbols to make it easier to read. This covers areas such as activities, likes and dislikes and finance. Support plans are regularly reviewed and keyworkers have monthly meetings with residents to discuss how things are going and if there are any changes. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 10 Residents are encouraged to be involved in decisions made about their lives. This is done through attending reviews, keyworker meetings and regular resident meetings. This approach is carried out throughout the day by staff who were seen to ask residents what they wanted to do. The manager stated that they are always looking at new ways to empower residents and offer real choices. Risk assessments are very detailed and carefully explain how to encourage someone to be independent while making sure they remain safe. For example issues of consent to medical treatment. Behavioural action plans also ensure that staff focus on why residents behave in a particular way, rather than look at it negatively. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 11 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): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy varied lifestyles of their own choosing. EVIDENCE: All residents have an activity plan which outlines the things they like to enjoy during the week. This includes bowling, day centre, visit to the pub, and an evening club. Some people also go to the Shout café. Staff try to encourage residents to do the things they want to do. Holidays are being planned for later in the year and each resident is able to choose what they would prefer. One person commented on a questionnaire that staff encourage their relative ‘to use and develop her particular skills and abilities’. Visitors are able to visit whenever they like. One relative said that ‘the staff and manager are always welcoming to friends and family of residents’. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 12 The manager is keen to make sure that all residents are aware of their rights as much as possible. This is encouraged by giving them information in a way that is easy for them to understand, either verbally or in an easy read format. A leaflet was seen on the noticeboard explaining about the Mental Capacity Act in a way that could be understood. One resident likes to have their monthly keyworker report read out to them. Contracts also make it clear to residents what their rights and responsibilities are in the home. Menus are displayed on the noticeboard and records of food actually eaten are kept. The menu shows that a good range of meals is offered which residents said they liked. During the inspection one resident returned with staff after doing a weekly food shop which they enjoy helping out with. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 13 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): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good support systems ensure that residents health needs are fully met. EVIDENCE: Staff were observed to offer support to residents in a way that gave them a choice. For example, one staff was seen asking ‘Do you want me to help you?’ before support is given. One resident has a particular health issue and has been able to make a decision about what medical support to have. Resident files contain good information on health and personal care needs. Health care checklists go into greater detail about health needs including eye tests, dental and medical appointments. Additional support is given from the multi-disciplinary team in Kingston which provides physiotherapy and speech and language therapy amongst other things. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 14 Medication profiles are kept in the medicine cabinet. These have a photo of each resident together with details of medication taken, any allergies and important notes. There is additional information in each residents file which contains details of why medication is taken and any possible side effects. Medication Administration Record (MAR) sheets are accurately filled in and showed no gaps. Records are kept of medication which is ordered and returned. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 15 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): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information about how to complain is provided, which ensures that all residents know who to approach if they have concerns. EVIDENCE: The complaints procedure was seen on the notice board in an easy to read format. Residents said they knew how to complain. There have been two complaints since the last inspection. These were both from neighbours and were dealt with appropriately. Complaints are well recorded and include action taken and the outcome for the complainant. Information about the protection of vulnerable adults (POVA) was also available on the notice board for residents to read. Policies and procedures are in place and POVA training is monitored to make sure all staff attend as necessary. A recent POVA allegation was investigated appropriately. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 16 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): 24, 25, 27, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and staff have been frustrated by slow progress on redecoration and refurbishment but manage to keep communal areas clean and homely. EVIDENCE: All areas of the home aware seen to be clean and tidy. The kitchen is due for refurbishment but there have been long delays in carrying it out. This was commented on by staff and residents who are frustrated with the lack of progress. A lounge area is comfortably furnished and there is a separate small dining area. There is only one bathroom and no separate shower, although there is a separate toilet. This means some residents may have to wait for a while if they want a bath. It was noted that the bath hot water temperature was usually recorded as 38°C which is below the recommended 43°C. This means that residents may have a bath in water that is not warm enough. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 17 The staff sleep in room and office is located in a separate building in the rear garden. There are no washing or toilet facilities which means that at night, sleep in staff have to go through the garden to access the main house. Staff said that this can be unpleasant if the weather is bad. The washing machine and drier are located in a shed like building together with the food freezer and cupboard for storing hazardous chemicals. Staff were concerned that this is unhygienic, particularly if soiled clothes are left waiting to be washed. The manager said that when the kitchen is refurbished, the freezer will be moved there. Another shed in the garden contained a lot of rubbish and broken equipment and was unlocked. The manager said that this was due to be removed. The inside of the house has been partly repainted but some areas are still to be done. Bedrooms are properly furnished and were seen to be personalised with posters, pictures and ornaments. One bedroom needed to be redecorated and the carpet was worn and stained. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 18 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): 32, 33, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive a good, person centred service from a competent, knowledgeable and supportive staff team. EVIDENCE: Staff were seen to get on well with residents and to offer support as needed. There has been a consistent staff team since the last inspection, although an acting deputy manager is covering someone on maternity leave. Staff on duty gave good feedback about the service saying it is ‘a really good home’ and were positive about the support from management. Some concerns were expressed about the environment. A staff handover discussion went into a lot of detail about each resident and this was discussed in a very positive way. Recruitment information is kept at Head Office and copies of relevant checks are held in the home. A monitoring sheet makes sure that each member of staff has had the necessary checks. Criminal Records Bureau (CRB) disclosures are renewed every year. There was a lack of information to follow up some Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 19 information being disclosed on one persons CRB. The manager confirmed that the issue had been dealt with but this had not been recorded on file. There is good monitoring of staff training and this ensures that core skills training such as food hygiene, health and safety, and POVA is undertaken regularly. The deputy manager was able to show who needed particular training in the future and that this was being booked in advance. Specialist training is discussed in supervision. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 20 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): 37, 38, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management approach to the home ensures that the service is run in the best interests of people who live there. EVIDENCE: The manager has been at the Tolworth Park since it first opened and has a very good understanding of each residents needs. She is fully aware of the strengths and needs of the service and is open in discussing these. The manager talked passionately about her commitment to making sure residents were central to the service provided. She is keen to make sure that residents are empowered to make choices and to decide how they want to live their Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 21 lives. The staff team are encouraged to support residents with this approach in mind. Regard Partnership regularly send out questionnaires to residents as part of the quality assurance process. Letters were seen in residents files thanking them for taking part in a survey in December 2006 and saying that feedback would be given in the New Year. This feedback had not been received. Health and safety responsibilities are closely monitored all necessary checks have taken place. Fire points, emergency lighting and fire equipment are checked every week. The fire system was serviced in November 2006. Hot water temperatures are recorded regularly. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 22 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 X 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 2 25 2 26 X 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 2 X X 3 X Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 23 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 Standard YA24 YA25 Regulation 23 Requirement To make sure that the home is suitable for the residents, the refurbishment of the kitchen must be completed and bedrooms decorated as needed, including replacing old carpets. The unwanted equipment must also be removed from the garden. In order to make sure residents can bathe in a comfortable temperature the hot water must be maintained at 43°C. In order to ensure that there is no risk of contamination, the freezer must be kept away from areas used for handling soiled clothes. To further protect residents and ensure that staff are fit to work at the home, any disclosed information on CRB must be fully investigated and recorded. So that residents know that their views are being listened to, the organisation must ensure that the results of any surveys are fed back to them. Timescale for action 01/09/07 2 YA27 23(2)(j) 01/08/07 3 YA30 16(2)(j) 01/08/07 4 YA34 19 01/08/07 5 YA39 24 01/08/07 Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 24 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 YA27 Good Practice Recommendations The home should look into ways to provide a separate shower area for residents so that there are better choices for washing and explore suitable facilities for staff who are sleeping in. Tolworth Park Road, 104 DS0000029148.V343566.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Tolworth Park Road, 104 DS0000029148.V343566.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. 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. You have been warned!