Inspection on 22/11/05 for 16, Curtis Road

This inspection was carried out on 22nd November 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 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 14/06/05

16, Curtis Road 23/11/04

16, Curtis Road 06/07/04

16, Curtis Road 03/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 Curtis Road, 16 16 Curtis Road Whitton Middlesex TW4 5PT Lead Inspector Louise Phillips Unannounced Inspection 22nd November 2005 10:00 Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 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 Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 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. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 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 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) www.unitedresponse.org.uk United Response Miss Louise Anne Gallagher Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 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. It is situated in a quiet residential area close to public transport, shops and other local amenities. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day with time spent talking to the manager, staff and viewing paperwork. A tour of the premises took place and staff and care records were inspected. Three of the staff on duty were spoken to during the inspection. What the service does well: What has improved since the last inspection? What they could do better: 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 DS0000017361.V269390.R01.S.doc Version 5.0 Page 6 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 Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 2 The assessment process ensures that the home is the right place for new residents to move to. EVIDENCE: Since the last inspection no new residents have moved into the home. The information contained in the file for residents living at the home demonstrates that there was a thorough assessment of their needs prior to moving in to ensure that they would receive a good level of support at the home. Documentation also provides details that the process of people moving to the home is individualised to ensure that the resident’s needs are considered throughout. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 6 and 10 The home works well to meet the needs of each individual, though developments are needed to ensure that the care plans are up-to-date. Improvements are needed for the staff to develop good practice in recording information about residents. EVIDENCE: The records for two residents were looked at and each had a wealth of information about their health and social care needs. The care plans are formatted as ‘active support plans’ for each person, providing details of who will arrange and provide the support required, the time frame for this and how the effectiveness of this will be monitored. For one resident this involves details of them developing skills in cooking, shopping and tidying their room. The format of these care plans is easy to follow and it is easy to identify the actual care provided. However, they are let down by the fact that it is not clear if they are current. This is because there is no date at which they were implemented, no date for when they are to be reviewed and they are not signed by either the keyworker, resident or their representative. The previous inspection required that all residents have a full review of their needs at least annually. Records demonstrate that reviews for each resident Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 9 have taken place with the care manager and various healthcare professionals within the past year, however the Registered Persons must ensure that the care plans in use at the home are reviewed regularly and signed by the keyworker and resident, or their representative. The record-keeping in each residents daily record book still needs to be improved as the current practice of leaving clear gaps between each entry is bad practice and can lead to fraudulent entries being made. All the staff team should be trained and made aware of accurate record-keeping techniques. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12, 13 and 14 Staff have a good understanding of the individual support needs of the residents, and assistance with activities is offered in such a way as to promote each persons individual interests. EVIDENCE: The resident’s files contain information on the different activities that they have been involved in throughout the week. Each resident has a ‘daily activity planner’ that details individual activities throughout the week and these are varied to individual needs and preferences. Included are details about activities such as swimming, shopping and spending time with relatives. The home also has its own minibus that is used to support residents to attend activities outside of the home. During the inspection this was seen being used to transport residents to the daycentre. The manager discussed that the minibus is also used to take residents out on an ‘ad hoc’ basis, such as going to the pub, cinema or local Christmas bazaars. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 11 The manager stated that at weekends each resident pursues their own interests, like seeing their relatives or benefiting from the use of the visiting volunteer who will take individuals out for a drink, or to watch a rugby match. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 20 and 21 Medication systems at the home are good and protect the residents. The manager has approached the subject of terminal illness and death of residents well, ensuring that the thoughts and wishes needs of those closest to them are taken into account in the event of this happening whilst at the home. EVIDENCE: The home has a good medication system, with appropriate records maintained of all medications kept at the home, and good record-keeping practices observed. United Response have a comprehensive policy on death and bereavement which details the procedures for staff to take in the event of the death of a resident and the possible support needs for other residents and staff. The manager described that in August this year she sent out individual letters to the closest relatives of each resident to ascertain their wishes, thoughts and comments regarding the ageing, illness and death arrangements for their relative at the home. The manager stated that the feedback from relatives on this was “…generally positive, as they said it reassures them…”, with others commenting that it was something that they hadn’t considered. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 13 A copy of a letter sent to relatives was seen and observed to approach the subject with sensitivity and acknowledgement that it is a difficult area for relatives to think about. In addition, relatives were asked to complete a questionnaire regarding their wishes if the needs of their relative change, and also arrangements regarding the funeral in the event that the resident dies whilst still living at the home. The manager showed examples of where she had worked with relatives to arrange pre-paid funerals for each resident at the home. The inspector is of the opinion that the manager’s actions on dealing with this sensitive area is an example of very good practice that should be shared with other services. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 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 the following standard(s): 23 Adult protection in this home is inadequate with the lack of staff training and understanding of adult protection issues potentially leaving the residents at risk of abuse or exploitation. EVIDENCE: The previous inspection required that all staff at the home receive training in the Protection of Vulnerable Adults (POVA). The manager showed records to demonstrate that staff had applied for this through Richmond local authority and that this is planned to occur in January 2006. Due to training not having been completed within the timescale the requirement has been restated. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 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 the following standard(s): 24 Good improvements have been made to the lighting and carpeting of communal areas in the home. Further work is required to ensure that each resident’s bedroom is homely in décor. EVIDENCE: Since the last inspection the home has enhanced the lighting in the hallways to make these much brighter areas. The lounge carpet has also been replaced to that of a lovely new carpet and lino in the dining area. The manager stated that funding has recently been obtained for the provision of equipment to enable the lounge area to be adapted into a sensory area during the daytime. The only area outstanding from the last inspection regarding the décor is the repainting of one resident’s bedroom. No progress has been made to address this, where black ‘scuff’ marks and paint peeling away from wall were observed. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34 and 35 Residents benefit from a committed and experienced team of staff at the home who have the right approach and skills to meet their needs. Recruitment checks need improvements to reduce the risk to residents. EVIDENCE: The home currently has three vacancies for one deputy manager and for two senior support workers. Since the last inspection the home has recruited a new support worker who was present during the inspection. He stated “…I feel well supported…”, by the staff and manager of the home, discussing that he is currently doing an induction programme which includes training in first aid, health and safety, manual handling and medication awareness. Staff training files showed that most staff had done training in essential areas identified above, with some staff currently undertaking NVQ Level 2/ 3 in Care training to improve their competences further. As a result residents get a good quality of support and care from the staff at the home. The manager maintains a record of the training undertaken by staff and where training is due, to ensure that all staff are adequately trained for their role. Two staff files were looked at and found to be well presented, with an index of contents to enable easy access to information. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 17 Each file includes appropriate details of the persons’ role, qualifications, experience, references, contract of employment and copies of identification. However, despite having a record of the disclosure number following a Criminal Records Bureau (CRB) check having been carried out, it does not detail if this is clear or not. Also, there is no evidence at the home that a POVA First check has been carried out on staff prior to their employment. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 39 and 42 Residents really benefit from living at Curtis Road because the home is run well and in the best interests of the residents. The organisation does not demonstrate that the health and safety of residents is promoted. EVIDENCE: The manager works well to achieve high standards for the home. Her management approach and style of leadership is positive and she works proactively to support and empower the team by encouraging staff to take on new roles to develop themselves. All staff have the opportunity to discuss work-related issues with their manager on a regular basis during supervision sessions, and also with the team during monthly staff meetings. Discussion with staff and the manager convey that there is a good team working at and that they are committed to supporting the needs and interests of residents at the home. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 19 The manager has worked well to implement the quality assurance systems at the home. This is evidenced through the questionnaires sent and received back by the home from relatives and healthcare professionals, where they were able to give their feedback on the service. The questions prompted feedback on how the respondent felt about the support given to the residents, communication they receive from the staff and organisation, accommodation, etc. The manager stated that she is going to compile a summary of the responses received to the relatives and healthcare professionals involved with the home. Since the last inspection good progress has been made to ensure that the Portable Appliance Tests are carried out regularly. Despite a requirement at the last inspection the water temperature at the home is still an issue. The weekly water temperature check record demonstrates that water is still being dispersed at temperatures ranging from 21 – 63 degrees centigrade. The manager showed correspondence that she had chased up this with Thames Valley organisation on a number of occasions, but that nothing had improved. This does not demonstrate that the organisation promotes the health and safety of the residents and this requirement is restated. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 20 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 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 2 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Curtis Road, 16 Score X X 3 4 Standard No 37 38 39 40 41 42 43 Score X 3 3 X X 2 X DS0000017361.V269390.R01.S.doc Version 5.0 Page 21 YES 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 the care plans in use at the home re reviewed regularly and signed by the keyworker and resident, or their representative. The Registered Persons must ensure that all staff working at the home receive training in adult protection (Previous timescale not met) The Registered Persons must ensure that one bedroom is repainted where the paint has come away from the wall (Previous timescale not met) The Registered Persons must ensure that the home maintains a record of the Criminal Record Bureau (CRB) checks carried out on all staff. A POVA First check must be received for all staff prior to their commencing work at the home. The Registered Persons must ensure that hot water delivery temperatures are set at around 43C (Previous timescale not met) Timescale for action 31/03/06 2 YA23 13(6) 31/01/06 3 YA24 23(2)(d) 31/01/06 4 YA34 19, Schedule 2 31/12/05 5 YA42 23(2)(j) 31/12/05 Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 22 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 YA10 Good Practice Recommendations The Registered Persons should ensure that staff are trained in safe record-keeping techniques. Curtis Road, 16 DS0000017361.V269390.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 DS0000017361.V269390.R01.S.doc Version 5.0 Page 24 - 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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