Inspection on 17/08/05 for 198, Powder Mill Lane

This inspection was carried out on 17th August 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 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

198, Powder Mill Lane 20/07/06

198, Powder Mill Lane 21/02/06

198, Powder Mill Lane 31/03/05

198, Powder Mill Lane 20/07/04

198, Powder Mill Lane 22/01/04

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Edenvale

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Chatsworth Care - Dawson House

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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 powder mill lane 198 Powder Mill Lane Whitton Middlesex TW2 6EJ Lead Inspector Simon Smith Unannounced 17 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 198 Powder Mill Lane Address 198 Powder Mill Lane Whitton Middlesex TW2 6EJ 020 8898 7445 020 8898 7445 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) United Response Ms Janice OBrien Care Home (CRH) 5 Category(ies) of Learning Disability (LD) 5 registration, with number of places powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21.12.04 Brief Description of the Service: The home is registered with the CSCI to accommodate a maximum of five adults with learning disabilities. The property is owned and maintained by the London & Quadrant Housing Association whilst the service is managed by United Response, a not-for-profit provider of community services for people with learning disabilities. The home is situated in a pleasant residential area and benefits from proximity to community resources as well as parks and open spaces. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 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 afternoon and involved discussion with residents, the manager, the deputy manager and members of the staff team. A sample of records was examined and a tour of the premises made. The inspector was made welcome throughout the visit and wishes to acknowledge the time and consideration that residents and staff provided during the course of the inspection. The home met 25 of 27 National Minimum Standards assessed at this visit. One Standard was exceeded and one Standard was almost met. The inspection was a positive one, providing evidence that residents receive high quality, individualised care from staff who know their needs well. Staff have a commitment to involving residents in the life of the home and make use of their knowledge and experience of residents to provide appropriate support in decision making. Residents are able to have privacy when they want it and staff talked to residents with respect during the inspection. Residents’ preferences about the care they receive are recorded and known by staff. Residents participate in a range of activities according to their needs and preferences. In addition to day services, residents take part in social and leisure activities, outings and holidays. Residents enjoy a high level of involvement in their local community and receive good support from staff to achieve this where necessary. Residents are registered with doctors locally and are supported by staff to get specialist advice or treatment when they need it. Some residents have complex healthcare needs, which are managed well by the home. Staff are currently investigating ways of improving communication opportunities for service users, including individual communication profiles and a specialist IT package. The manager and most of the staff team have worked at the home for some time, although one full-time and one part-time member of staff had started work at the home since the last inspection. New staff are recruited according to written policies and the home carries out appropriate checks before they start work. New starters attend induction and core training and all staff receive good support and supervision in their work. What the service does well: Identifies residents’ accordingly. powder mill lane needs effectively and delivers care and support G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 6 Involves and consults residents in the life of the home. Supports residents in making informed choices about their lives. Promotes and supports residents’ participation in their community. Provides opportunities for residents to access a wide range of social and leisure activities. Encourages and enables clear communication amongst staff and residents. New staff receive a good induction to the home and clear guidance in their work with residents. 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. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 Residents’ needs and strengths are effectively identified. Residents receive good support to achieve their goals and aspirations. Staff liaise effectively with other agencies where necessary. EVIDENCE: Care plans indicated that residents’ needs are effectively identified through the assessment process and that this information forms the basis of care and support delivered. The home is committed to ensuring that individual plans are person-centred and reflect the needs and aspirations of residents. Staff liaise effectively with other agencies and residents receive support to access specialist services where necessary. The design and layout of the home meets the needs of those who live there. Adaptations and specialised equipment have been installed where necessary to improve mobility. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 10 Care plans are person-centred and reflect the care provided to residents. The manager and staff understand residents’ individual needs. Residents receive good support to make informed choices about their lives. EVIDENCE: An individual plan of care is in place for each resident. A standard format is used for this purpose and the standard of recording was found to be good. Care plans record residents’ strengths, needs, likes and dislikes and record individual goals. All residents experience communication difficulties to some degree. As a result staff make use of their knowledge and experience of residents and their individual methods of communication. Staff are currently working with residents to develop individual communication profiles. These documents identify residents’ personal communication methods and provide guidance for staff in their work with residents. The manager advised that the profiles would be updated every six months and that all new staff will be familiarised with powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 10 their contents. The home also has access to an IT system which is designed to improve communication opportunities for residents. Staff have a commitment to involving residents in the life of the home and promoted choice and individual responsibility during their interactions with residents during the inspection. Observation indicated that staff have a good awareness of residents’ needs and preferences and utilise this knowledge to provide appropriate support. Staff interacted positively with residents during the inspection, providing meaningful engagement and encouraging residents to participate in activities appropriate to their needs. Staff work within the Confidentiality policy developed by United Response. The policy sets out clear guidelines for staff concerning the storage, access, handling and usage of confidential information and has been developed with appropriate reference to the Data Protection Act (1998). All sensitive information was found to be stored appropriately within the Home. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 17 Residents participate in a range of activities appropriate to their needs and preferences. The manager and staff are committed to supporting residents in community participation. The home’s menu is varied, well balanced and takes account of residents’ preferences. EVIDENCE: Resident participate in a range of activities appropriate to their needs and preferences. Four residents attended Whitton Community Resource Centre on the day of inspection. One resident visited Kingston in the morning with staff and went for a walk in the afternoon. Two residents were supported by staff to visit Bushy Park. The manager and deputy manager both reported that increasing community presence and participation of residents remains a primary objective for the service. Staff are encouraged to think creatively about how residents can access community facilities and resources. As a result, the home performs well against this Standard. Residents access powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 12 community resources and facilities locally and have the opportunity to participate in holidays and a range of leisure activities. The home has an allocated vehicle, which facilitates excursions and outings in the local community and further afield. Responsibility for cooking and preparing food is shared amongst the staff team. This is appropriate given the size of the home. All staff undertake basic food hygiene training as part of their induction process. The advertised menu indicated that the home provides a varied and well-balanced diet. Residents are encouraged to contribute to menu planning. Snacks and drinks are available to residents at any time. The home caters for specific dietary needs where needed. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 Staff are aware of residents’ needs and preferences relating to their care. Changes in need are effectively identified. Residents’ privacy and dignity are maintained. Residents are supported to access specialist healthcare resources where necessary. EVIDENCE: Staff on duty demonstrated a good awareness of residents’ healthcare needs. Care plans identified residents’ individual support needs and contained guidance for staff delivering care. Staff were observed to maintain the privacy and dignity of residents throughout the inspection, whilst personal care needs were met appropriately. Residents were afforded sufficient time to complete tasks at their own pace. The inspection provided good evidence that any changes in residents’ needs are effectively identified and that staff respond appropriately to these changes. For example, the manager and one member of staff are currently working with one resident to address changes in need associated with aging. The home also seeks specialist advice from community healthcare professionals where powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 14 necessary. A resident who experiences mobility difficulties receives regular visits from a physiotherapist and has had an assessment to identify suitable mobility aids. The home had responded appropriately to increased incidences of challenging behaviour. Input had been sought from appropriate healthcare professionals and the issue addressed with the staff team to ensure that all adopt a consistent approach in their work. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Clear guidance is provided for staff in the recognition, prevention and reporting of abuse. EVIDENCE: The home works within the framework of the local authority‘s ‘Joint Policy on Suspected Abuse of Vulnerable Adults’. United Response provides training for all care staff in issues relating to the protection of vulnerable adults on the ‘Prevention from Harm’ course. The manager advised this forms part of organisation’s core training for staff and that staff attend refresher training every two years. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28, 30 The home is comfortable, safe and well maintained. The home is clean and hygienic. Communal and private rooms are spacious, homely and reflect residents’ preferences. EVIDENCE: The home is situated in a pleasant residential area and has good access to local community facilities, open spaces and public transport networks. A high standard of decoration has been achieved throughout and the home benefits from a large rear garden, which had been improved since the last inspection. A number of residents chose to spend time in the garden during the afternoon. Communal rooms were welcoming and homely and private accommodation indicated individual tastes and preferences. Toilet and bathroom facilities are accessible and are available in sufficient numbers to meet the needs of residents. All areas of the home were clean and hygienic. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 17 powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36 Staff have an awareness of their own and one another’s’ roles. Staff communicate effectively with one another and have a good awareness of residents’ needs. Staff have access to training appropriate to their roles. Staff receive effective induction, supervision, and appraisal. EVIDENCE: The majority of staff have worked at the home for some time. As a result, residents are cared for by staff who are known to them and who know them well. The manager reported that that one full-time and one part-time member of staff had started work at the home since the last inspection. The full staff complement for the service comprises the manager, deputy manager, four fulltime posts and two part-time posts. The manager advised that approximately one full-time equivalent post remains vacant. Vacant shifts are currently covered by bank or regular agency staff. Two staff files were examined. Both provided evidence of an appropriate recruitment procedure, including application form and interview, and contained powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 19 proof of identity. One file did not contain two suitable references. See Requirement 1. The manager is an NVQ assessor and reported that staff respond positively to training opportunities. Two permanent staff have achieved National Vocational Qualifications since the last inspection. There is an expectation that new staff will register for NVQ training if they not already achieved a National Vocational Qualification. All new starters undertake a formal induction and undertake the Learning Disabilities Award Framework (LDAF) induction if they have not already done so. Guidance and training is available to staff for specific roles within the service. Staff spoken to on the day of inspection confirmed that they receive regular supervision and good support to carry out their delegated responsibilities. All staff are issued with the General Social Care Council ‘Code of Conduct’. Regular staff meetings and use of systems such as handovers and the Communication book, ensure that staff are well briefed on current issues within the home. The frequency of staff meetings has decreased but the team now allocate a whole day to monthly meetings. The manager advised that this change has realised many benefits for the home, as staff are now able to address key issues indepth and to invite guest speakers to address the group. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 42 Systems of recording and administration within the home are clear and well organised. The home has an effective and experienced manager. Staff work within defined guidelines and a clear procedural framework. Staff are committed to maintaining high standards of health and safety within the home. EVIDENCE: Systems of recording and administration within the home are clear and well organised. The manager has a number of years experience in her role and clearly knows the home and residents well. The manager is committed to the development of the service and demonstrated a positive approach to the inspection process. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 21 The manager is an internal trainer for United Response and is involved in the delivery of ‘The Way We Work’ programme. This training aims to underpin the values and working practices of all staff within the organisation. In addition, staff work within the range of policies and procedures developed by United Response. The home has an appropriate fire detection system. Staff conduct fire alarm tests on a regular basis. Clear instructions for use in the event of a fire were prominently displayed. The kitchen is equipped with a fire blanket and extinguisher. The Home was clean, hygienic and free of obvious health and safety hazards on the day of inspection. Standards of food storage were satisfactory. All COSHH products were stored appropriately. The home maintains an Accident book. powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 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 x 3 3 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 4 3 x x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 powder mill lane Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 3 x G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 23 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 34 Regulation 19(1)Sch 2 Requirement Timescale for action 30.10.05 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 Good Practice Recommendations powder mill lane G54-G04 S17386 Powder Mill V239375 170805 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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. 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