Inspection on 28/08/05 for 11 Kenton Road

This inspection was carried out on 28th August 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

11 Kenton Road 03/01/07

11 Kenton Road 24/02/06

11 Kenton Road 06/01/05

11 Kenton Road 14/09/04

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 08/07/2008.

CARE HOME ADULTS 18-65 11 Kenton Road 11 Kenton Road Harrow Middlesex HA1 2BW Lead Inspector Virginia Allen Unannounced 28 August 2005 12.00 noon 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 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 Stationary 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. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 11 Kenton Road Address 11 Kenton Road Harrow Middlesex HA1 1BW 020 8423 8090 020 8933 0307 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Residential Care Providers Ltd Nigel Brookarsh Care Home 6 Category(ies) of LD 6 registration, with number of places 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 6th January, 2005 Brief Description of the Service: 11 Kenton Road is a registered care home providing personal care and accommodation for 6 adults aged between 18 and 65 who have learning disabilities. The registered provider is Residential Care Providers Ltd. The manager is Mr Nigel Brookarsh. The home is a three-storey house situated on a busy main road in Harrow. It is close to all community facilities and amenities. Community transport is accessible but the home has its own transporter. Initial registration was in 2000. All the bedrooms are single with no en-suite. There is a rear garden with seating which is accessible through the kitchen or the dining room. At the time of the unannounced inspection, the home had full occupancy. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place during a sunny Sunday afternoon in August. Five of the service users were present. One service user was on holiday with her family. The inspector spoke with each resident and with each of the three staff members on duty. The inspection was supported by a senior support worker and the manager was contacted on the telephone to answer any outstanding queries. The home presented as homely and the service users wandered freely about the kitchen and lounge areas. The home was clean and tidy. The inspector reviewed service user’s assessments, care plans, medication records and problem sheets. Documentation was precise and detailed. The inspector would like to thank the staff for making her welcome and providing her with all the requested information. What the service does well: What has improved since the last inspection? What they could do better: The home could do with minor redecoration in some areas. The lounge and the dining room carpet need to be cleaned and kept clean. The kitchen fire door and the cosh cupboard door require adjustment to ensure that they close safely and positively. All staff must have epilepsy training to ensure their competence if an emergency arises. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 6 The service user should assist with the planning of their own care and care plan documentation should reflect their input. The carpet in one bedroom had a strong odour and should be cleaned or replaced. 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. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Prospective user’s individual needs are assessed comprehensively. However, documentation reflecting service user’s wishes could be improved. EVIDENCE: During the inspection, assessment documentation for each service user was reviewed. It was found to be comprehensive and detailed. A full picture was presented of the service user’s history and their current needs. Documented assessments also included recommendations from the GP as well as allied health professionals such as the Chiropodist, Audiologist, Optician, Dietician or the Specialist Nurse. Staff and service user interviews suggested that care is focused on service user wishes, however, documentation of this information could be improved. Service user involvement in their care plan needs to be well documented. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 Service users assessed and changing needs and goals are reflected in their individual plans, but documentation of personal wishes needs to be improved. Service users did make decisions about their own lives with assistance and participate in aspects of home life. EVIDENCE: Fortnightly service user meetings are held to discuss aspects of home life. These meetings are held to encourage service users to make their personal wishes known. The service user is present at the six monthly review of their care plan where they are encouraged to participate in any decisions about changes in their care. The inspector viewed a care plan that had been revised the previous week and which reflected a high level of individualisation. However, documentation to reflect the service user input should be improved. The individual care plans are generated from a comprehensive set of assessment documents covering all aspects of personal, social and health care needs. The care plans are straight forward and clear. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 10 Documentation reflected service user’s preferred method of communication. For example, staff might use particular words that have meaning to the service user and which facilitates understanding between the service user and the staff. The service user makes their wishes known through communication or behaviour. All effort is made to attend to the wishes of the service user and while documentation of this needs to be improved, during the inspection service users were calm and comfortable. Management reported that they were currently negotiating for the use of independent advocacy for each service user. Plans are underway for one resident to use their own cash card under supervision. The other five residents are not able. Individual service user records are stored in a room which is kept locked and which requires a pin number to enter. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 Service users have opportunities for personal development. They take part in culturally appropriate activities and are part of the local community. Service users engage in appropriate leisure activities and are encouraged to spend time with their families. Their rights are respected and there is evidence of a healthy and individualised diet. EVIDENCE: The inspector was informed by the senior carer that four of the six service users attend college. They are enrolled in courses such as music, computing, art, craft, gardening and pottery. One service user works at a garden centre once a week. Daily activities are documented and service users participate in a range of community activities. They attend any local fete, concert, band display or face painting activities in the park. Two service users have their own computers. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 12 Staff told the inspector that two service users have been identified as “artistic” and their talent is encouraged through activities such as stitch craft or scratch foils. One service user goes to the library. Service users have been on two group holidays this year - to Butlins and Centre Park. The inspector was told that they are encouraged to holiday with their family and one service user is currently holidaying in Scotland. Management reported that they document family contact and are pro-active in organising family contact. The service user is encouraged to entertain friends and family in their own rooms. When service users receive mail, staff report that this is opened with the service user and read to them. Management is culturally sensitive and explained that one service user is of Asian decent and he is taken to Asian films or Asian theatre productions when possible. Two service users are Jewish, hence their meat and food preparation is Kosha. One of them is involved in the performing of a religious ceremony on Fridays. One service user is African and African food is served once a week. The staff are a cultural mix of white British, Jewish, Asian and African. The weekly food menu is recorded and displayed on the kitchen wall. The week of the inspection, the menu was varied and nutritious. One resident who likes only particular foods has her own menu. Residents who attend college or day centre take a packed lunch of sandwiches and fruit. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20,21 Service users receive individualised personal support and their physical and emotional health needs are met. One user gives her own medications with supervision. Documenting of medication needs tightening. Ageing, illness and death wishes of the service user are documented. EVIDENCE: Documentation on five of the service user’s care plans showed that they have a shower or a bath morning and evening. One service user is showered once a day. During the inspection the service users were clean and tidy. Staff reported that the service users are encouraged to choose their own clothing each day. Documentation showed that service users visit allied health professionals regularly. One service user has recently seen a dietician due to her dislike of some of the home’s menu choices. The dietician made recommendations and these changes were reflected in the individual care plan. Another service user has recently been given a hearing aid. This has improved his communication and interaction within the home community. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 14 One service user has epilepsy and is visited by the epilepsy nurse. However, epilepsy training is needed by all staff but the management is having trouble accessing this. Medication sheets were reviewed and gaps were observed. Staff need to be more accurate about signing for medications at the time of delivery. It was explained to the inspector that one service user gives her own medication under supervision. The medications are kept in her room in a locked cupboard. She has the key. Staff report good communication between staff and the local pharmacist. Each service user has ageing, illness and death wishes recorded in their documentation. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Service users are listened to and their views acted on. They are protected from abuse, neglect and self-harm EVIDENCE: Service users meet each fortnight with management and staff to discuss their needs and wishes. Management supervises service user money. The individual key worker for each service user keeps records of expenses, dates and amounts spent. These records were viewed by the inspector and were in order. All but one bedroom was light, airy and free from odour on inspection. bedroom had an offensive odour which must be addressed. One One service user has begun to have aggressive outbursts. He has communicated with management that he likes his own space and it appears that he has become irritated with community life. Management are endeavouring to organise alternative accommodation for him. During the inspection the service user had a behaviour event. Staff dealt with this in an appropriate manner and the behaviour ceased. Management reported that all staff have had abuse training from the Mulberry organisation. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 16 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,27,28,30 The home was homely, comfortable and safe. Bedrooms suited the needs of the service users. Toilets and bathrooms provided sufficient privacy and shared spaces complimented service users bedrooms. The home was clean and hygienic. EVIDENCE: The home was homely, comfortable and safe. The service users shared a lounge with a TV. During the inspection two of the service users spent time watching the TV. One service user moved back and forth between the dining room and the outside garden area. There were two washing machines and two dryers. One set is used for service user’s washing while the other set is used for the home laundry such as tea towels etc. The service user washing machine had broken down over the weekend. This will be addressed after the Bank holiday. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 18 Each of the service users showed the inspector their bedroom. They were clean and tidy with individual decoration. Some maintenance of the shared area was required. The kitchen door and the cosh door required re aligning. It was noted that the carpet in the lounge and the dining room was badly stained and requires deep cleaning or replacing. One bedroom carpet had a strong odour. Management reported that this was a new issue and the problem would most likely be resolved. However, significant damage has already been done to the carpet. This needs to be resolved. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,35,36 Service users are supported by competent and qualified staff who meet their joint needs. Service users benefit from well supported and supervised staff. EVIDENCE: The home has a manager, three senior support workers to supervise and support the support workers. The home has a stable workforce, with no recently employed staff. They use full time as well as part time staff. Seven of the nine staff have undergone NVQ level 2 or level 3 training. Two of the staff are social workers. Staff reported that they were happy with staffing levels and that this meant that stress levels were in control and that the service user benefited. There were 3 or 4 staff members on the morning shift with 3 staff on the evening shift. One person slept in over night. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 20 All staff had undergone Induction training and LADF (Learning Disability Awards Framework Training. Management is having difficulty accessing training funded by the local council. This must continue to be addressed. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 Service users are confident their views underpin all self monitoring, review and development of the home. EVIDENCE: Each two weeks there is a meeting of service users and staff, a staff meeting and a seniors meeting. At these meetings service user issues are discussed. Management report that the home is person centred and the focus of discussion is what is best for the service user and what the service user wishes. All staff on the morning and the evening shift were interviewed by the inspector. They were informed and enthusiastic. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 x 3 3 x 2 Standard No 11 12 13 14 15 16 17 3 3 3 4 3 3 x Standard No 31 32 33 34 35 36 Score x 2 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 11 Kenton Road Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 24 24 24 Regulation 23 (2) (d) 23 (2) (d) 23 (4) (i) (c 19 (5) (b) 13 (2) Requirement The lounge carpet was stained in places and requires deep cleaning or replacing. The dining room carpet was stained and in need of deep cleaning or replacing. The kitchen fire door and the coshh cupboard door require adjustment to ensure that they close safely and positively All staff must have epilepsy training Medication forms must be more accurate. They should contain a signature or an explanation in each slot where the medication has been ordered by the GP Documentation should reflect service user input into their care plan. Carpet in one bedroom has strong odour. The carpet needs to be cleaned or replaced. Timescale for action 15/1/06 15/1/06 15/10/05 4. 5. 32 20 15/10/05 15/10/05 6. 7. 7,8 25, 30 12 (2) (3) 16 © 15/10/05 15/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 24 No. 1. 2. Refer to Standard 19 Good Practice Recommendations Allied health recommendations need to inform the care plans and be documented in care plans. 11 Kenton Road G62-G11 S17542 11 Kenton Rd v212198 190805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 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. 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