Inspection on 05/07/06 for 18 London Road

This inspection was carried out on 5th July 2006.

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

18 London Road 18/06/08

18 London Road 05/02/06

18 London Road 05/06/05

18 London Road 15/10/04

18 London Road 04/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 18 London Road Luton LU1 3QU Lead Inspector Mr Pursotamraj Hirekar Unannounced Inspection 5th July 2006 01:15 18 London Road DS0000014932.V303075.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 18 London Road DS0000014932.V303075.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. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 18 London Road Address Luton LU1 3QU 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) 01582 877383 01582 721098 Fairhome Care Group Limited Annette Yvonne Robinson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 18 London Road is a home registered to provide long term personal and social care for up to 6 adults with a learning disability aged over 18 years. The home is a large detached property situated on a busy main road near to Luton town centre and local amenities. All service users have their own individually decorated bedrooms but five out of six share bathing facilities. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the unannounced key inspection carried out on 05/07/06 over 4 hours by pursotamraj hirekar. The method of inspection included review of outstanding requirements, study of care plans, risk assessments, discussion with the service users’, staffs on duty, partial tour of the premises and observations. The staff on duty coordinated the entire 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. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide enabled potential service users to make informed decisions. EVIDENCE: The home had no new admission since the previous inspection. The statement of purpose and the service user guide were comprehensive to enable any potential service user to make informed choice and decision. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made comprehensive needs assessment and had developed detailed care plans of service users’ which were implemented as planned. EVIDENCE: The needs assessments and care plan reviews were carried out of all the 6 service users’ every six months. On this inspection 3 service users’ care documents were seen. Service user – 1 had full assessment of need on admission and the social worker, service user, and senior support worker and deputy manager on the 23/06/06 undertook the recent care plan review. Service user –2 Care plan review was held on the 21/06/06 at service user’s mum’s place to suite service user’s mum. The participants for the care plan review included service user, service user’s mum, support worker, senior support worker, and social worker and service user’s brother. Service user – 3 Care plan review was carried out on 19/06/06 at the home. The participants included service users’ 2 sisters’ service user and manager. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 9 The needs assessments, care plan reviews and care plans were comprehensive and covered areas such as aims and actions from the last review, supervision and behaviour, independent living skills, daily activities, community contact, medical and therapeutic interventions, medication, communication and relationships, health and safety, finances and new action points. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had consultations with all service users’ individually and developed activites that meet the individual service users’ needs and aspirations to achieve quality of life goals. EVIDENCE: The home had prepared all service users’ independent activity plan that enabled each service user to actively participate and achieve quality of life goals. A random sample of 3 service users’ details are as follows: service user – 1 Aims and actions from last review– to withdraw service user’s day care placements, offer more daily activities because the service user was at home all the time. Supervision and behaviour – out lined service user’s behaviour was now well settled, outburst of behaviour is under control. Independent living skills – service user required more support on daily basis, holidays, and outings. Community contact – service user enjoyed going to town and had been to various parts of London in last few months. Service user sees her family regularly. Service user –2 Aims and actions from the previous review – to encourage the service user to use tooth brush, to organise food and drink 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 11 intake to help in dieting, to help her prepare her own breakfast and other meals. Supervision and behaviour – service user appeared to be happy at most of the time, enjoys watching TV and quite independent and takes what ever she wants to. Independent living skills – service user independent skills were improving and still require support and walks around the house herself, needs support for personal hygiene, like going out for walks, cinema. Community contact – service user regularly goes out for walks, for long walks uses wheel chair, visited London, zoo, sea side, planned a week’s visit to black pool in end of July, 06. Day centre - Attends bramingham day centre 5 days a week and was happy at the day centre. Service user – 3 Areas of action from the previous review – to do more activities and more exercises to help weight loss, staff to encourage service user for more walks and bike exercise, to arrange transport on Mondays and Saturdays 2 hours each day to visit her Mom, sometime service user’s sister come to pick her up. Service user was encouraged to improve fitness and help in using washing machine for laundry. Supervision and behaviour – service user was reasonably independent, as she was able to prepare her own breakfast and dinner and clean the table. Service user gets upset when her sister doesn’t turn up to pick her up on Saturdays. Independent living skills – service user required assistance in bathing, washing hair, quite reluctant to go out lot of the time. However, she looks forward to 21 clubs on Wednesday’s. Community contact – service user visits her family regularly, need encouragement to participate in other activities, enjoys playing with the cube, goes out for food and shopping with the home staff. The home had planned to take the service user for a week in the end of July to Blackpool. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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): 18, 19, and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed personal and health care needs of the service users’ were met as per the care plan. EVIDENCE: The home had made appropriate arrangements to meet the assessed personal and health care needs of the service users’. The details of 3 service users’ randomly selected were as follows. Service user –1 Medical and therapeutic interventions – appointments with GP, district nurses, chiropodist, psychiatrist all the appointments were regular. Medication – staff administer the medication. Communication and relationships – service user get on well with the staff team and other service users and likes going shopping, and enjoys one to one contact. Health and safety – a comprehensive risk assessment was carried out which include 13 areas. Finance – CP receives income support and the home staff managed disability allowance – the money and the service user also had a lockable money cabinet in her bedroom which she had access to. New action points – continue to liaise with social services to reassess the needs of service user and to apply for a leisure card to receive discount. Service user – 2 Medical and therapeutic interventions - GP, nurse, bowl management clinic, walk-in centre all these 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 13 appoints were regular and psychiatrist appointments were done as and when required. Communication and relationships – continued to maintain good relationship with the staff and other service users’. Service user does not communicate verbally but can express her feeling through face and hand rubbing. Health and safety – risk assessment s were carried out for the following areas that include mobility, epilepsy, eating, accessing the community, heavy doors. Finances – The homes had managed all the money transactions and were recorded appropriately. New action points – staff to increase recreational activities and communicate with day care centre with regard to completing food intake records. Service user – 3 Medical and therapeutic intervention – Changed her GP because the service user’s mum was not happy with the GP. Service user visits the GP, psychiatrists, ENT clinic and to the dentist regularly. Medication –was administered by the home staff. Communication and relationships – attend 21 club and does not socialise much. However, gets well with family and had good working relations with the staff and always helps other service users’. Health and safety – 6 areas have been assessed for risks. Finance – were managed by the home staff, service user also had lockable cabinet in her bedroom and a purse in which she carries money when she goes on shopping. New action points – the home need to write a goal plan with service user to decrease the use of the cube playing especially when going out. Support to improve fitness and health and visit her mom on Saturday and Monday. The home had installed a new medicine cabinet for storage. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements with regard the complaints policy and procedures. Service users’ views were listened to and acted upon by the home. EVIDENCE: The home had a comprehensive complaints policy and procedure and the summary was displayed in the office room. There were no complaints recorded. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements for service users’ to live in a homely, comfortable and safe environment and was maintained without any offensive odours. EVIDENCE: One service user’s bed room furniture was replaced which includes a chest of drawers, side cabinet, wardrobe in April 2006 following the inspection in February 2006. Health and safety checks carried out that included weekly fire checks, weekly water temperature checks, weekly room temperature checks, monthly fire door checks, emergency lighting checks monthly, 6 monthly heat and smoke detection checks, annual fire alarm system check, annual fire precaution checks, fire fighting equipment system annually, weekly window restrictor lock checks, wheel chair check monthly and monthly wardrobes check were regularly monitored by the staff of the home. Annually risk assessments were carried out for curtains, paddling pool, luggage, personal care assistance, shopping, assisting service users’ to get up from bed, refuse bin and waste 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 16 bags, replace light bulbs, moving furniture and appliances, supporting unsteady service users while walking, using fire fighting equipment, laundry, wheel chair use, using vacuum cleaner, heavy sauce pans and kitchen equipment. Kitchen utensils and appliances, wet floor, cooker, knifes, medicine cupboard, electrical wires, TV, video, open windows, combustible waste, fire exit doors, window locks and fire emergency, hot water, ice and frost formation on the stairs and footpath leading to wards the home, food poisoning, medication overdose, insufficient diet, locks on bed rooms locks on garden gates, use of hand blender, glasses and mirrors, gloves, staircase, and disposable shaving raiser. The home was in the process of replacing the stair carpet. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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 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): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a good skill mix of staff that complemented with team work. EVIDENCE: The home had carried out staffs training needs assessment and developed and staff training calendar. Trainings such as continence training, rectal Valium, fire safety were implemented since the previous inspection and the others were planned to be implemented. Details of discussion with one staff are as follows: Staff member -1 had joined the home in 02/2001 as a bank support worker and had gradually grown to become a senior support worker since 12/2004. The qualifications include NVQ3 in care and had received training both in-house and external which include fire safety, moving and handling, food hygiene, adult abuse, epilepsy management, challenging behaviour management, control and restraint, medication awareness and first aid. Staff supervision was held once in every 2 months. Have good team working approach and enjoyed working at the home. Staff personnel files with information regarding references, CRB were not available on this inspection as the manager and the deputy were not on duty and the senior support worker had no access to such information. However, on 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 18 10/07/06 the manager had sent across details with regard to recruitment process and staff CRB checks. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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 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): 37, 39 and 42 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The manager and the staffs work as a team in the interest of service users’. EVIDENCE: The manager and the staff work as good team and have maintained good working relations with the service users’. Staff supervision and trainings were planned and held. The staffs have had good skill mix that complement the needs of the service users’ at the home. At the time of this inspection, though the manager and the deputy manager were not available the senior support worker was able to coordinate the inspection systematically. The home was well managed and had appropriate internal monitoring systems and practices with regard to the delivery of care services. Health and safety management, staff management, contact and relationships with the external professionals and relevant institutions and service users’ family members’ were developed and maintained in the best interest of the service users’. The home had sent out questionnaire before 26/06/06 to day care centres, service users’ families, GP, psychiatrists and out reach and service users’ and staffs. All the 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 20 questionnaires were expected back on or before 05/07/07. The senior support worker had said that some questionnaire have been received though she would not have access to the same to be verified. The home had planned to analyse the information received through these questionnaires and take appropriate actions were required to improve service delivery and also inform the relevant stakeholders of the actions taken. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 YA24 Good Practice Recommendations The home should replace the stair carpet. 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 18 London Road DS0000014932.V303075.R01.S.doc Version 5.2 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. 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!