Inspection on 08/12/05 for 191, Kneller Road

This inspection was carried out on 8th December 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

191, Kneller Road 17/09/07

191, Kneller Road 13/06/06

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 Kneller Road, 191 191 Kneller Road Whitton Middlesex TW2 7DY Lead Inspector Simon Smith Unannounced Inspection 8th December 2005 11:15 Kneller Road, 191 DS0000017376.V261248.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 Kneller Road, 191 DS0000017376.V261248.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. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kneller Road, 191 Address 191 Kneller Road Whitton Middlesex TW2 7DY 020 8898 5431 020 8898 5431 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) The Regard Partnership Limited Mr John Webster Ms Jackie Reid Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: 191 Kneller Road provides five places to home is owned and operated by the Partnership operates a number of other, area and continues to expand at a national adults with learning disability. The Regard Partnership. The Regard similar services in the surrounding level. The home is situated in a pleasant residential area of Whitton yet is within walking distance of the high street, which offers a range of community facilities. Richmond and Kingston are within easy reach and public transport links are good. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the course of a single visit and involved speaking to residents, the manager and members of staff. A sample of records was examined and a tour of the building made. The inspector was made welcome and wishes to thanks residents and staff for their help during the inspection. The home met 21 of 23 National Minimum Standards assessed at this visit. Two Standards were almost met. Three Requirements and one good practice recommendation were made. The home had responded well to the last inspection report, taking action to meet all the Requirements made. There was one resident vacancy at the time of inspection and one new member of staff had joined the team since the last visit. Residents were busy and active during the inspection. One resident went Christmas shopping with staff support while other residents attended day services. All residents went out for a meal together at lunchtime. The home had been repainted since the last inspection and much of the first floor recarpeted. As a result the home looked smart and well maintained. What the service does well: What has improved since the last inspection? What they could do better: Obtain evidence of Criminal Records Bureau disclosures for all advocates. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 6 Ensure that staff are appointed only after checks against the Protection of Vulnerable Adults (POVA) list have been carried out. Ensures that all potentially harmful substances are stored safely. 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. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 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 Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 5 There is clear information about the service provided and staff have considered how to make this information accessible to residents. There are appropriate procedures governing assessment and admission for new residents. The terms and conditions of residents’ placements should be clarified in writing with funding authorities. EVIDENCE: The home has produced a Statement of Purpose, which gives details of the services and facilities provided and the aims and objectives of the home. A Service User Guide is issued to all residents. The manager provided evidence that staff have considered how to make these documents more accessible to residents and that information for residents had been personalised where possible. Appropriate procedures governing assessment and admission for new residents are in place. All prospective residents have an assessment prior to moving in. Admissions are made then initially on a trial basis. The last inspection report made a Requirement regarding contracts for residents. The manager was able to demonstrate that contracts had been Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 9 drawn up for residents outlining the terms and conditions of their placements and that copies had been sent to care managers for their signature as representatives of the placing authority. In a number of cases care managers had been unwilling to sign the contracts, reporting that the placing authority had drawn up a separate service agreement. As a result, residents of the home do not have standard contracts but different terms and conditions depending on those set out by their placing authority. Some service agreements examined did not adequately specify the details of the placement. It is recommended that the Contracts department of the Regard Partnership contact residents’ placing authorities clarifying the services to be provided as set out in Standard 5 of the National Minimum Standards for Care Homes for Adults (18-65). Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 There is a commitment to improving residents’ individual plans. Staff understand residents’ individual needs. Residents are supported to make informed decisions about their lives. EVIDENCE: An individual care plan is in place for each resident. The manager was able to demonstrate that systems of recording, including care plans, are under review as the home seeks to make improvements in this area. Residents meet with their keyworkers each month to review progress against individual goals. The manager reported that keyworkers aim to ensure that goals identified reflect residents’ individual needs and that objectives are specific, measurable and time-limited. The manager and staff demonstrated a good knowledge of residents’ individual needs and a commitment to supporting residents in making informed decisions about their lives. A speech and language therapist was due to visit the home the day after inspection to discuss the implementation of a ‘Total Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 11 Communication’ project. The aim of the project is to improve understanding of residents’ individual communication strategies and needs. The home supported one resident’s aim of moving to another home nearer her family in July 2005. As a result the home had once vacancy at the time of inspection. The manager stated that she is working with the Regard Partnership’s Referrals Manager to identify prospective residents. It is considered that the service manager is not best placed to perform this role and that this function falls within the remit of the Referrals team, although the manager must be involved in the assessment process when a prospective resident is identified. The Regard Partnership provides appropriate guidance for staff in the identification and management of risk. Risk assessments are in place addressing specific activities undertaken by residents. These assessments are subject to regular review. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Residents access day services according to their needs and preferences. Residents receive good support to access their local community. Interactions between staff and residents was positive. The home’s menu is varied, well balanced and is developed with input from residents. EVIDENCE: Residents access a range of day opportunities appropriate to their needs and preferences and are involved in their local community. The deputy manager took one resident Christmas shopping on the day of inspection. All residents went out for lunch with staff support on the day of inspection. Residents are supported to maintain relationships with their friends and families. Staff advised that two residents have regular social contact with advocates. (See also Standard 34) Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 13 Interactions between staff and residents was positive during the inspection. Residents have unrestricted access to all communal areas of the home. Residents’ wishes and needs are clearly identified in their individual plans. Staff used appropriate forms of address when speaking to residents. The advertised menu indicated that the home provides a varied and wellbalanced diet. Responsibility for cooking and preparing food is shared amongst residents and the staff team. All staff undertake basic food hygiene training as part of their induction process. Standards of food hygiene and storage were good. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 Residents’ healthcare needs are recorded and known by staff. Residents are supported to access community and specialist healthcare resources where necessary. EVIDENCE: A standard format is used to identify and record service users’ healthcare needs and preferences relating to their care. Residents choose their rising and retiring times. Staff support residents to maintain their personal appearance in a manner which reflects their personality. All residents are registered with local general practitioners and access other community healthcare resources as necessary. The inspection provided evidence that changes in residents’ needs are effectively identified and that staff respond appropriately to these changes. For example, one resident currently has regular input from the community psychiatry team. The manager reported that the home has a good relationship with the local healthcare services and that community practitioners provide valuable support to the staff team. The community nurse visited on the day of inspection to work with residents in developing individual health plans. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 15 Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Training and guidance is provided for staff in the recognition, prevention and reporting of abuse. EVIDENCE: The home works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’. The Regard Partnership has a Whistle-blowing procedure, which enables staff to report any concerns about malpractice they may have. The manager reported that all staff had attended Protection of Vulnerable Adults (POVA) training in August 2005. The manager advised that the member of staff who had recently joined the staff team had not attended POVA training with the Regard Partnership but had done so with her previous employer. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28 The home is comfortable, safe and well decorated. The communal rooms of the home are welcoming and homely. Residents’ bedrooms reflect individual preferences. EVIDENCE: The home is situated close to the amenities and public transport facilities of Whitton. Communal rooms include a large living/dining room and a conservatory, which affords access to a large garden. The manager advised that contractors had recently visited the home to provide estimates for work to tidy the garden. The home had been redecorated since the last inspection and the majority of the first floor recarpeted. As a result the standard of décor was high. Communal rooms were welcoming and homely and residents’ bedrooms reflected individual preferences. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 18 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, 34, 35, 36 Job roles within the service are clear and defined. Staff receive effective induction, supervision and support. Evidence of pre-employment checks must be obtained for all staff and volunteers. EVIDENCE: The home has a clear staffing and management structure. Job descriptions and contracts of employment are in place for all posts within the staff team. A clear shift plan was observed to be in place, listing residents’ appointments and activities and identifying the member of staff responsible for support. Two residents have regular social contact with advocates. Although it is acknowledged that these arrangements have been made through an established independent advocacy group, the home must obtain evidence of Criminal Records Bureau disclosures for all advocates. See Requirement 1. One member of staff had started work at the home prior to a check against the POVA list. All staff appointments must be made only after checks against the POVA list have been carried out. See Requirement 2. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 19 Staff spoken to during the inspection reported that they are encouraged to attend training relevant to their roles. A number of staff are registered on NVQ courses. The manager reported that lack of access to an approved assessor had limited progress in achieving these awards but that the Regard Partnership had recently appointed an assessor. The manager advised that staff meetings taking place every two weeks. A staff meeting was planned for the day after inspection. The manager confirmed that all staff receive regular supervision. The inspector spoke to one member of staff who had recently joined the service. The member of staff confirmed that she had received a thorough induction to the home from the manager, which addressed areas including health and safety and operational policies and procedures. The member of staff also reported that she had received valuable support from colleagues since beginning work and that she had discussed her training needs with the manager. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 20 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): 39, 42, 43 The home aims to seek and respond to residents’ views. Effective quality monitoring systems are in place. EVIDENCE: The home aims to seek residents’ views through weekly meetings, which are supported by staff. Residents are encouraged to involve themselves in the routines of the home and are consulted about decisions in the home that affect them. There is a development plan for the home. The Regard Partnership has developed effective internal Quality Assurance monitoring systems and recently allocated a manager to prepare monthly service monitoring reports, copies of which are submitted to the CSCI. The organisation has also demonstrated a commitment to involving residents, staff and other stakeholders in the development of services, policies and procedures. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 21 A potentially harmful (COSHH) product was accessible in the first floor bathroom. Whilst the risk to residents was low, all substances potentially harmful to health must be stored appropriately. See Requirement 3. Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X X 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kneller Road, 191 Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 3 DS0000017376.V261248.R01.S.doc Version 5.0 Page 23 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 YA34 Regulation 19(1)&(3) Timescale for action The Registered Person must 30/12/05 obtain evidence of Criminal Records Bureau disclosures for all advocates. The Registered Person must 15/12/05 ensure that staff are appointed only after checks against the POVA list have been carried out. The Registered Person must 15/12/05 ensure that all potentially harmful substances are stored safely. Requirement 2. YA34 19(1)&(2) 3. YA42 12(1)(a) 13(4) 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 5 Good Practice Recommendations The Registered Person should contact residents’ placing authorities to clarify the services to be provided by the home (as set out in the National Minimum Standards). Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 Page 24 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 Kneller Road, 191 DS0000017376.V261248.R01.S.doc Version 5.0 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. 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