Inspection on 17/09/07 for 191, Kneller Road

This inspection was carried out on 17th September 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

191, Kneller Road 13/06/06

191, Kneller Road 08/12/05

191, Kneller Road 07/06/05

191, Kneller Road 04/11/04

191, Kneller Road 25/05/04

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 18-65 191, Kneller Road Whitton Middlesex TW2 7DY Lead Inspector Simon Smith Unannounced Inspection 17th September 2007 16:30 191, Kneller Road DS0000017376.V351420.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 191, Kneller Road DS0000017376.V351420.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. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 191, Kneller Road Address Whitton Middlesex TW2 7DY 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) 020 8898 5431 020 8898 5431 The Regard Partnership Ltd Mr John Webster Ms Jackie Reid Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2006 Brief Description of the Service: 191 Kneller Road is home to five adults with learning disabilities. The home is owned and operated by the Regard Partnership. The Regard Partnership operates a number of other, similar services in the surrounding area. The home’s fees range from £1495 to £2130 per week. The home is situated in a pleasant residential area and has good access to public transport networks and shopping and community facilities. A good standard of decoration has been achieved throughout the home and the property has a well maintained garden. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector used evidence from a range of sources when making judgements about the home. These included visiting the home and talking to residents, staff and the deputy manager. Some written information was checked, including staff and residents’ files. The inspector was made welcome during the visit and wishes to thank all those who gave their views about the home. The home met 28 of 31 National Minimum Standards assessed at this visit. Three Standards were almost met. Three residents filled in surveys with support from staff and returned these to the CSCI. Residents said that they like living at the home and feel safe and well cared for. Residents also said that they are supported to make decisions about their lives and that they can have privacy when they want it. The manager and most staff have worked at the home for some time and know residents’ needs well. The home had two staff vacancies at the time of inspection. The deputy manager said that two new staff had been appointed and were waiting for clearance to start work. What the service does well: What has improved since the last inspection? Much of the information on residents’ care plans has been updated. Risk assessments have been reviewed and updated. Residents’ meetings are held more often. Staff have individual supervision more often. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 6 New kitchen worktops and units have been installed. 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. The summary of this inspection report can be made available in other formats on request. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written information about the home is available to residents. Residents’ needs are effectively assessed. Residents are able to visit and stay at the home before deciding to move in. Residents are issued with a written agreement that sets out the terms and conditions of their placement. EVIDENCE: The Regard Partnership has produced a Statement of Purpose and a Service User Guide about the home. The organisation produced a new booklet entitled ‘Service users’ Rights and Information’ in May 2007 that sets out residents’ rights regarding dignity, respect, choice and privacy. The booklet also contains the organisation’s Complaints procedure in an accessible format. Residents are also issued with a contract that sets out the terms and conditions of their placement. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 9 A new resident moved in to the home in June 2007. The deputy manager said that a clear transition plan had enabled the resident to settle in well. The transition plan included several visits to Kneller Road and a number of overnight stays. The deputy manager also said that staff from the resident’s previous placement worked closely with staff from the home on a number of shifts before the resident moved in. The residents’ files checked during the inspection contained up to date needs assessments. A care plan for the new resident was being developed. There was evidence that the home had obtained good information from the resident’s previous placement about his strengths and needs and had guidelines for staff to ensure that they work consistently with the resident. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Care plans record residents’ needs and strengths and provide guidance for staff delivering care. Some monitoring forms were not completed and need to be filled in regularly. Residents receive support to make choices about their lives. The home supports residents in taking manageable risks. EVIDENCE: The home had updated much of the information on residents’ care plans since the last inspection. The care plans checked contained an individual profile and good information about residents’ strengths, needs and preferences. Individual risk assessments were incorporated into residents’ care plans. One resident’s 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 11 last care management review took place over a year ago and another resident had not had a care management review since October 2003. The home should contact residents’ placing authorities where there has been no care management review in the last twelve months. Whilst there was evidence that the home draws up care plans to address residents’ individual needs, the documentation in place to monitor one resident’s behaviour was incomplete. The blank documents included ‘behavioural action plans’, ‘behavioural plan evaluation forms’ and ‘functional analysis charts’. The home must ensure that all documentation necessary to evaluate and monitor residents’ needs is complete and up to date. See Requirement 1. Residents are supported to make choices about their daily lives and are consulted about decisions that affect them. Staff know residents’ needs well and the home consults significant others, such as family members and care managers, about residents’ care where necessary. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 – 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 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. Residents participate in activities according to their needs and preferences. Residents are involved in their local community. Residents’ rights and responsibilities are promoted. The home’s menu is varied and well balanced. EVIDENCE: Residents have individualised programmes of activities and are involved in their local community. Some residents use a local resource centre and attend sessions including art, literacy and communication. Residents’ care plans 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 13 provided evidence of activities including cycling, swimming, walks, meals out and visits to the pub. Residents have access to independent advocacy services and are registered to vote. Residents’ rights regarding dignity, respect, choice and privacy are set out in the ‘Service users’ Rights and Information’ booklet. The menu indicated that the home provides a varied and well-balanced diet. Responsibility for cooking and preparing food is shared amongst the staff team. All staff undertake basic food hygiene training as part of their induction process. The meal prepared by staff during the inspection looked appetising and was well received by residents. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Residents’ healthcare needs are met. The home seeks the advice of other professionals where necessary. Residents’ medication is appropriately stored and recorded. EVIDENCE: Care plans provided evidence that residents are supported to obtain medical treatment if needed and that healthcare professionals are involved in residents’ care where necessary. Some residents have had input from speech and language therapy in the past and the community nurse is available if required. The deputy manager said that the home has developed a good relationship with the local community team and that they provide useful guidance for staff delivering residents’ care. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 15 There is an appropriate system for the storage of medication and clear protocols for administration. The home has an agreement with the supplying pharmacist for the provision of advice and regular inspections. Staff said that the community team psychiatrist reviews residents’ medication several times each year. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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 has a clear Complaints procedure. Staff are trained in the recognition, prevention and reporting of abuse. EVIDENCE: The “Service Users’ Rights and Information” booklet contains the Regard Partnership’s Complaints procedure in an accessible format. The booklet also provides information about bullying and abuse. The Regard Partnership has a Whistle-blowing procedure, which enables staff to report any concerns they have about poor practice. The complaints record provided evidence that the home responds appropriately to any complaints received. The service works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’. The policy offers definitions of abuse and provides guidance for staff in the recognition and reporting of abuse. All staff receive training in the Protection of Vulnerable Adults. There was evidence that the home obtains Criminal Records Bureau disclosures for people who work with residents, such as the advocate and aromatherapist. The home keeps records of all residents’ financial transactions and receipts for expenditure. Records and balances for two residents were checked and found to be accurate. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 17 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 28 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 is safe and well maintained. The communal rooms of the home are comfortable and homely. Residents’ bedrooms reflect individual preferences. The home is clean and hygienic. EVIDENCE: The home is a two storey terraced property in Whitton, with good access to local community facilities, open spaces and public transport networks. There is off-street parking for two vehicles at the front of the home and a large garden to the rear. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 19 The shared rooms of the home include a large lounge/dining room, a conservatory and a kitchen. Residents’ bedrooms are personalised and reflect their individual tastes and preferences. New kitchen worktops and units have been installed since the last inspection. The lounge carpet had been damaged in an accident just before the inspection and was to be replaced in the near future. All areas of the home were clean and hygienic. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Job roles within the service are clear and defined. Staff are appointed following an appropriate recruitment and selection procedure. Staff attend training appropriate to their roles but some staff need refresher training in core areas. Staff receive good supervision and support. EVIDENCE: Staff work to a clear shift plan and there is always a nominated shift leader on duty. There were two staff on duty with three residents at the time of inspection. Both members of staff were part of the permanent staff team. One member of staff had taken two residents out for a drive. At night the home employs waking night and sleep in staff. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 21 The home had two full-time vacancies at the time of inspection. The deputy manager said that two new staff had been appointed and were awaiting clearance to start work. The deputy manager said that permanent staff cover most vacant shifts and that regular bank staff are available to cover any outstanding hours. Most staff have worked at the home for some time and know residents’ needs well. One new member of staff had started work at the home recently. Staff records provided evidence that new staff have an induction to the home and that all staff have regular supervision. Staff on duty said that they had access to good support in their jobs and that the manager or deputy manager are available when they need them. The Regard Partnership carries out appropriate pre-employment checks on staff before they start work, including Criminal Records Bureau disclosures. The staff training record indicated that some staff need refresher training in core areas including food hygiene, moving and handling and health and safety. See Requirement 2. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced and committed manager. Staff support residents to contribute their ideas to the running of the home. Standards of health and safety are generally good but the home must provide evidence that some important safety work has been completed. EVIDENCE: The manager and deputy manager have worked at the home and have established a stable management team for the home. Staff on duty said that 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 23 they get good support from the management team and opportunities to contribute their ides to the running of the home. The Regard Partnership seeks the views of people who use its services through an annual Quality Assurance exercise. Service users’ relatives and appropriate professionals also have a chance to have their say about Regard Partnership services. The deputy manager said that residents’ meetings are held several times each month. Staff also attend these meetings and support residents to plan the home’s menu, discuss activities and raise any issues that are important to them. The home has an appropriate fire detection system and a fire risk assessment was carried out in October 2006. The home’s fire fighting equipment was serviced in July 2007 and the alarm system and emergency lighting were checked in August 2007. The most recent fire drill took place in September 2007. Staff carry out weekly health and safety checks around the home. An Electrical Installation Report was issued in June 2007 and portable electrical appliances were tested in July 2207. There was evidence that the home’s water storage tank has been professionally cleaned and disinfected but records state that the next inspection was due in July 2007. See Requirement 3. Safety records contained correspondence from British Gas and Transco identifying necessary remedial work but there was no available evidence that this had been completed. The home must demonstrate that this work has been carried out. See Requirement 4. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 2 X 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 12 17 Requirement The Registered Person must ensure that all documentation necessary to evaluate and monitor residents’ needs is complete and up to date. The Registered Person must ensure that all staff attend regular refresher training in core areas. The Registered Person must demonstrate that treatment checks on the water storage tank has been professionally cleaned and disinfected. The Registered Person must demonstrate that the remedial work identified by British Gas and Transco has been completed. Timescale for action 30/11/07 2 YA35 12 18 30/11/07 3 YA42 23 30/11/07 4 YA42 23 30/11/07 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 26 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 YA6 Good Practice Recommendations Contact residents’ placing authorities where necessary to ensure that care management reviews take place annually. 191, Kneller Road DS0000017376.V351420.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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