Inspection on 14/06/05 for 16, Curtis Road

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

16, Curtis Road 06/07/06

16, Curtis Road 22/11/05

16, Curtis Road 23/11/04

16, Curtis Road 06/07/04

16, Curtis Road 03/02/04

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Chatsworth Care - Tudor Lodge

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Curtis Road,16 16 Curtis Road Whitton Middlesex TW4 5PT Lead Inspector Loouise Phillips Announced 14th June 2005 10:00am 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. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Curtis Road, 16 Address 16 Curtis Road Whitton Middlesex TW4 5PT 020 8898 6026 020 8898 6026 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) United Response Miss Louise Anne Gallagher Care Home only (PC) 4 Category(ies) of Learning disability (LD) registration, with number of places Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 23rd November 2004 Brief Description of the Service: 16 Curtis Road is a care home providing personal care and support to four adults with a learning disability. The service is managed by United Response and the building owned by Thames Valley Housing Association. The home is purpose-built and wheelchair accessible throughout with a large well-maintained garden to the rear of the property. The home is situated in a quiet residential area close to public transport, shops and other local amenities. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day and took approximately 5 hours. A tour of the premises took place and care records were inspected. Three members of staff on duty and one of the service users were spoken to. Three comment cards were received in relation to the service. The comments were positive apart from two areas, where it was indicated that there is not always a senior member of staff to talk to at the home and that staff are not always aware of the health issues of service users when talking to healthcare professionals. What the service does well: What has improved since the last inspection? What they could do better: Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 6 The service has a number of areas that could be improved on regarding the practices involving the review of service users’ care, record keeping of daily notes and plans regarding the ageing, illness and death of service users. Environmentally the home requires attention to the lighting in the hallway, which is dim and unwelcoming. The lounge carpet also needs replacing where it is stained in areas. The service users bedrooms are nice and homely, however one room was seen to need re-painting where paint had worn away from the wall. Requirements have also been made to ensure that appropriate checks are carried out on the portable appliances (eg. kettles, television, etc) and the temperature of the hot water to ensure the safety of the service users. 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. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 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 Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 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) 5 There is an adequately detailed contract regarding the terms and conditions of the service users accommodation. EVIDENCE: Two service users files were examined and both found to contain a copy of the contract detailing the terms and conditions of their stay at the home. This document is formatted as an ‘Individual Charter’ which details what United Response will provide in relation to accommodation, food, confidentiality and the expectations regarding visitors and the behaviour of service users. The contracts were seen to be signed by the service user or their representative. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 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 and 10 The needs of the service users are met with support plans in place to identify the daily care needs of each service user. However, the home does not demonstrate that the service users support and care needs are kept under review. EVIDENCE: Two service users files were examined and were found to contain a lot of information about the health and social needs of each service user. These included records of health-related appointments plus guidance from physiotherapy and speech and language therapy services on dealing with service users’ physical health needs. Both service user files contained a ‘pen profile’ of the likes, dislikes and individual support needs for activities. Each file also had good information on personal care needs, moving and handling guidelines and appropriate communication methods for use with the service user. The two files each contain an ‘active support plan’ which details who will take responsibility for arranging and providing support and the time frame for this. The plans also states that the support needs will have a ‘full review in six months’, however this is vague as there is no date for the implementation of Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 10 the plan which has also not been signed. The previous inspection recommended that all service users have a full review of their needs at least annually and the Registered Persons must ensure that these take place and are accurately recorded. Risk assessments are individualised to service users activities both inside and outside of the home, including use of transport and the hydropool. Further risk assessments seen in the files were seen to take into account the physical needs of individuals. An eating and drinking risk assessment for one service user was seen to have been devised jointly with the input of the speech and language therapist. A record is maintained of the daily occurrences for each service user, with entries being made throughout the day. The inspector observed that there were clear gaps between entries made eg. the leaving of gaps of blank spaces between daily records, which can lead to fraudulent entries being made. It is recommended that the staff team be trained in accurate record-keeping techniques. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 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 and 17 Good positive relationships have been formed between the staff and service users. The staff have a good understanding of the service users needs and support with activities is offered in such a way as to promote individual needs and interests. EVIDENCE: The manager discussed that service users were supported according to their individual needs and interests to develop their social, behavioural, emotional and independent living skills. During the inspection one service user was observed spending time watching the television, whilst the other service users were at local daycentres. The service user files contain information on individual preferences such as swimming, shopping, going for walks and spending time with relatives. The manager stated that the home has a minibus that is used to support service users to attend activities outside of the home, such as going to the hydropool. The manager discussed that the minibus is also used to take service users out for meals and to any local events occurring in the community. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 12 Each service user file contains a ‘daily activity planner’ that details individual activities throughout the week and are varied to needs and preferences. These, along with the support plans indicate that service users are offered a range of leisure activities on a structured and ad hoc basis, such as going to the pub or cinema. The meals at the home are all prepared by the care staff. Each service user has individual needs in relation to the nutritional content of the meals and the subsistency of the food and these are well catered for. The individual requirements are further detailed in the service user files, along with guidance on appropriate meal choices from the dietician. The weekly menu was observed to be displayed in the kitchen area and the fridge, freezer and cupboards were well stocked with a selection of meats, dairy produce, fruit and vegetables. The inspector observed that all interactions between service users and staff were respectful and positive, with a good friendly rapport between all parties. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 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 and 21 Personal support is offered in a way that promotes and protects service users privacy, dignity and independence. EVIDENCE: The personal care needs are identified in service user files in the format of guidance procedures and support plans. The manager discussed that staff offer support with personal care to service users to varying degrees dependant on individual abilities. The manager stated that the times for waking are flexible, dependant on the wishes of the service user and their daily plan of activities. The home demonstrates good close working relationships with various healthcare professionals, which is evident in the service user files. Information and guidance was seen to contain input from speech and language therapy, dietician and physiotherapy services. The ageing, illness and death of a service user are not currently dealt with or planned for. The manager stated that it is an area that she is planning to address with service users and their relatives. This is a sensitive area and should be handled with respect and as the service user would wish. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 14 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 and 23 The home has a satisfactory complaints policy and procedure in place. EVIDENCE: There is a satisfactory complaints procedure in place at the home, which was seen displayed on the office area. The procedure is included in the Service Users Guide and contains the contact details of the Commission for Social Care Inspection. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 15 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, 26, 27, 28, 29 and 30 The standard of the décor within the home is generally of a good standard and presents as an attractive and comfortable environment for service users. EVIDENCE: On entering the home you are met with a hallway that is spacious, though poorly lit and not particularly homely. A tour of the building showed that there is a good standard of décor, with good ventilation and natural lighting throughout all other areas. The lounge carpet was noted to be stained in areas and the manager stated that there is a plan to replace this carpet and also to install new dining furniture. The accommodation within each bedroom was observed to be furnished with the necessary specialist equipment to support individual service users in their daily activities and personal care needs. Each bedroom was of a different colour, with different furnishings and individually personalised by the service users. One bedroom was observed to require re-painting where the wall had been ‘scuffed’ and paint had come away from the wall. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 16 Discussion with the manager indicated that the staff carry out the cleaning of the home as part of their duties. On the day of inspection the home was cleaned to a high standard throughout. There is a large garden to the rear of the home that is designed to enable easy access by wheelchair from the house. Records indicate that a monthly hazard check is carried out by staff at the home, with areas of concern appropriately dealt with. The previous inspection required that the magnetic door holder on the kitchen door is fixed so it can be held open safely. This was observed to have been carried out and checked weekly for any faults. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 17 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, 33, 34, 35 and 36 The information contained in the staff files is good and demonstrates that the good recruitment procedures. EVIDENCE: The manager stated that the home currently has three staff vacancies and the manager stated that it is anticipated that two new staff are due to start in September 2005. The previous inspection required that all staff files contain the required information. Two staff files were examined and found to be adequately maintained and contain all the relevant information required by the Care Homes Regulations 2001. The staff files examined also contained a record of two-monthly supervision and recent appraisals. At the time of inspection the home had a new member of staff who was undergoing their induction programme. Appropriate documentation in relation to their induction, role and responsibility was seen to be included in their file. The home is working towards ensuring that all staff have an NVQ in Care, with three staff having obtained an NVQ level 2 in care/ working with people with learning disabilities. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 18 The training records demonstrate that staff have undertaken training in fire safety, moving and handling, health and safety, medication awareness and first aid. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 19 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) 37, 39, 41, 42 and 43 The home does not demonstrate that the views of relatives, professionals or any stakeholders of the service are sought. Some areas around health and safety need addressing as a matter of priority. EVIDENCE: The manager recently returned to the home following a period of secondment from another service. The manager is registered with the Commission for Social Care Inspection as is appropriately qualified for her role. The previous inspection identified two areas of health and safety requiring attention that were followed-up on this occasion. The Portable Appliance Testing was carried out on 17th November 2004, however some checks were identified as needing a six monthly check and these were seen to have not been carried out and it is required that this is addressed within the timescale. It was also identified that the hot water delivery temperature be set to around 43C. The weekly water temperature check record indicates that water is Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 20 dispersed at temperatures ranging between 20.3 – 63.2C. Documentation also demonstrates that the boiler was last tested on 9th May 2005, where it was identified that the pump needs replacing, however this has not occurred and it is required that this be replaced as a matter of priority. The home maintains appropriate checks regarding the fire system, fire call points and evacuations. The home currently has a quality assurance format for seeking the views of relatives and professionals involved with the service. The manager stated that this had not been carried out in past year and that she is aiming to send out questionnaires to relevant people with the next coupe of months. The manager further stated that she is planning an ‘away day’ for staff to enable the team to reflect upon the past year and discuss plans for the future, so that these can be used to develop the service. The budget for the service was seen be adequate, with a record of spends and deficits maintained. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 21 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 x x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Curtis Road,16 Score 3 3 x 2 Standard No 37 38 39 40 41 42 43 Score x 3 2 x 2 2 3 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 22 NO 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. Standard YA6 Regulation 15(2)(b) Requirement The Registered Persons must ensure that all service users have a full review of their assessed needs at least annually. The Registered Persons must ensure that adequate lighting is provided in the hallways throughout the home. The Registered Persons must ensure that the carpet in the lounge is replaced. The Registered Persons must ensure that one bedroom is repainted where the paint has come away from the wall. The Registered Persons must implement a quality assurance system to review the quality of the service and seek feedback from service users, their representatives and all parties involved with the service. The Registered Persons must ensure that the Portable Appliance Testing is carried out every six months where necessary. The Registered Persons must Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 23 Timescale for action 31/08/05 2. YA24 23(2)(p) & (d) 30/09/05 3. YA39 24(1) 30/09/05 4. YA42 13(4) & 23(2)(j) 31/07/05 ensure that hot water delivery temperatures are set at around 43C. 5. 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. 2. Refer to Standard YA10 & YA41 YA21 Good Practice Recommendations The Registered Persons should ensure that staff are trained in safe record-keeping techniques. The Registered Persons should ensure that the ageing, illness and death of each service user are dealt with and planned for with the involvement of the individual and their representatives. Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RD 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. Extracts may not be used or reproduced without the express permission of CSCI Curtis Road,16 G54 G04 S17361 Curtis Road V228886 140605 Stage 4.doc Version 1.30 Page 25 - 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. 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