Inspection on 21/02/06 for 198, Powder Mill Lane

This inspection was carried out on 21st February 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 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

198, Powder Mill Lane 20/07/06

198, Powder Mill Lane 17/08/05

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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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,198 198 Powder Mill Lane Whitton Middlesex TW2 6EJ Lead Inspector Simon Smith Unannounced Inspection 21st February 2006 10:00 Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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 Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Powder Mill Lane,198 Address 198 Powder Mill Lane Whitton Middlesex TW2 6EJ 020 8898 7445 020 8898 7445 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) United Response Ms Janice O`Brien Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th August 2005 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. 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,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place from 10.00am until 1.40pm and involved speaking to three residents, the manager, deputy manager and two members of staff. A sample of records was examined and a tour of the building made. The inspector was made welcome and wishes to thank residents and staff for their help during the inspection. The home met 21 of 24 National Minimum Standards assessed at this visit. Three Standards were almost met and three Requirements were made. One of the strengths of the service is that the manager and staff have worked there for some time. As a result, residents are cared for by people who know them and their needs well. Staff get good support to do their jobs and have access to training. New staff receive a good induction when they start work. Residents are encouraged to use their local community and are consulted about the life of the home. United Response is trying to improve the support residents get from staff. The manager has attended training recently in person-centred planning and said that training for other staff will be held soon. United Response is committed to improving its services and asks residents and staff what they think of the organisation. Staff had recently been asked to give their views in a detailed survey. What the service does well: Promotes residents’ participation in their community. Provides good support to residents in maintaining contact with their friends and families. Responds well to any changes in residents’ needs. Enables access to specialist resources where necessary to meet residents’ needs. Encourages residents. and promotes effective communication amongst staff and Provides good support for staff to do their jobs. What has improved since the last inspection? The manager has attended person-centred planning training. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 6 One resident has been supported to reintegrate into day services and also receives day services at the home. One resident has been supported to obtain a mobility aid more suited to his needs. 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,198 DS0000017386.V261291.R02.S.doc Version 5.1 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 Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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, 3 The home makes available clear information about the service it provides. There are appropriate procedures for the admission of new residents. EVIDENCE: The home has produced a Statement of Purpose, which gives details of services provided and the philosophy of care. A Service User Guide is available to all existing and prospective residents. Appropriate procedures governing assessment and admission are in place. No residents have been admitted since the last inspection. The home is registered to accommodate residents between the ages of 18 and 65 years. The manager advised that one resident has reached the age of 65. The Registered Person must therefore submit an application to the CSCI to vary the home’s registration category. See Requirement 1. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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 the following standard(s): 6, 9, 10 Individual plans are regularly reviewed and reflect residents’ needs and aspirations. There is a commitment to person-centred planning Risk assessments are in place where needed, but these must be reviewed more regularly. All sensitive and/or confidential information is stored securely within the home. EVIDENCE: Each resident has an individual care plan, which records their strengths, needs, likes and dislikes and preferences in terms of routine. Goals and aspirations are recorded and the support needed to achieve these objectives is identified. All the care plans examined had been recently reviewed. The manager reported that service managers have attended two days of person-centred planning training since the last inspection. The manager advised that United Response has developed a corporate strategy for the Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 10 delivery of person-centred planning across the organisation. The strategy includes the development of person-centred planning tools and the provision of training for staff to enable them to work effectively with this approach. United Response provides appropriate guidance for staff in the identification and management of risk. Risk assessments are in place addressing specific activities undertaken by residents. A number of risk assessments on file required review. See Requirement 2. United Response has a Confidentiality statement, to which all staff are expected to work and which complies with the Data Protection Act (1998). All confidential or sensitive information was found to be stored appropriately within the home. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16 Residents participate in a range of activities appropriate to their needs and preferences. Staff are committed to supporting residents in achieving high levels of community participation. Residents receive good support to develop and maintain relationships with their families and friends. Residents are treated with respect by staff. Residents rights are recognised and upheld. EVIDENCE: Residents attend a variety of day services according to their needs and preferences. All residents attend Whitton Community Resource Centre, which provides a range of in house activities and outings. Resource centre staff currently visit the home to work with one resident for two hours each week. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 12 Residents are actively involved in their local community, using shops, cafes, pubs and other community resources. Staff reported that all residents have some contact with their families and that most have relatives that visit. Staff keep family members who are not able to visit the home informed about events affecting their relatives. The input of residents’ relatives is sought at reviews. Residents are encouraged to celebrate birthdays and other occasions with parties at the home. One resident recently celebrated his 50th birthday and plans were being made for one resident’s 60th birthday party. Interactions between staff and residents was positive during the inspection. Residents have unrestricted access to all communal areas of the home and are able to have privacy when they want it. Residents’ wishes and needs are clearly identified in their individual plans. Staff used appropriate forms of address when speaking to residents. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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 the following standard(s): 19, 20 Residents are supported to access healthcare resources where necessary. The home must improve the written guidelines for residents’ medication. EVIDENCE: All residents are registered with local general practitioners and access other community healthcare resources as necessary. Staff on duty demonstrated a good knowledge of residents’ healthcare needs and an awareness of individual guidelines for delivering care. The home seeks specialist advice from healthcare professionals where necessary. For example, one resident who experiences mobility difficulties receives regular visits from a physiotherapist and had an occupational therapy assessment to identify suitable mobility aids. The inspection also provided evidence that long term conditions experienced by residents, such as epilepsy, are managed well with the input of appropriate healthcare professionals. There is an appropriate system for the storage and administration of medication. All medication coming into or leaving the home is recorded. There are clear protocols governing the administration of medication. There are no residents who self medicate. Sample signatures for staff who administer Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 14 medication are held on file. Medication Administration Records contain photographs of residents. Inspection of medication records for three residents indicated no errors in recording Some information held on file regarding individual medication guidelines for residents was inconsistent. For example, one resident’s medication file contained conflicting guidelines for the use of diazepam. The home must ensure that individual medication guidelines are accurate, clear and up to date. See Requirement 3. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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 the following standard(s): 22 Appropriate procedures are in place for the management of complaints. EVIDENCE: The home has an appropriate Complaints procedure. United Response provides guidance for staff on handling complaints received and specifies timescales for action and response. The organisation has also developed a Whistle-blowing procedure, which enables staff to report any concerns they have about malpractice. A record of complaints is maintained. No complaints have been made about the service since the last inspection. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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 the following standard(s): 24, 25, 27, 28 The home is comfortable, safe and well maintained. Communal are welcoming and attractively decorated. Bedrooms are 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. Communal rooms include a lounge and separate dining room, which provides access to a large, well maintained garden. Toilet and bathroom facilities are available on both floors of the home. A good standard of decoration has been achieved throughout the property. Communal rooms were welcoming and homely and private accommodation indicated individual tastes and preferences. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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): 31, 32, 33, 34 There is a stable staff and management team who know residents and their needs well. Staff have an awareness of their own and one another’s’ roles. Staff communicate effectively with one another. Staff are appointed following an appropriate recruitment and selection procedure. EVIDENCE: The home had vacancies for one full-time member of staff and one part-time member of staff at the time of inspection. The manager and staff have worked at the home for some time and, as a result, residents are cared for by staff who are known to them and who know their needs. There is a clear staffing and management structure. Job descriptions and contracts of employment are in place for all posts within the staff team. Staff communicated well with one another during the inspection and engaged meaningfully with residents. 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. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 18 The manager reported that the staff group work well as a team and the deputy manager said that morale within the staff team is high. The management team said that staff are encouraged to question the working practices of the home and to raise issues for discussion. Staff meet monthly for a whole day and use these opportunities to invite guest speakers. The most recent staff meeting took place on the 8 February 2006. Staff files provided evidence that staff are recruited according to a robust recruitment procedure and are required to provide proof of identity, appropriate references and Criminal Records Bureau disclosure before they start work. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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): 39, 40, 41 United Response is committed to obtaining the views of service users and staff. There is a commitment to identifying areas for potential improvement. Staff work within clear written guidelines and codes of conduct. Systems of recording and administration are well organised and maintained. EVIDENCE: United Response is committed to obtaining the views of people who use and work within the organisation’s services. Residents are consulted about decisions taken within the home. Each resident has a keyworker, who aims to provide advice and support where required. Staff have recently been asked to participate in a comprehensive survey, which seeks their views about all aspects of the organisation and their role within it. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 20 The United Response Development Team was due to visit the home in the week after inspection. The manager advised that the team observe working practices and interaction within the home to identify any potential areas for improvement and development. Systems of recording and administration within the home are well organised and maintained. Written information is clear and usable by staff. Staff are issued with a ‘Code of Conduct’ and work within the policies and procedures developed by the organisation. Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 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 3 2 3 3 2 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 X ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 X STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X X X 3 3 3 X X Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 22 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 2 3 Standard YA3 YA9 YA20 Timescale for action Section 24 The Registered Person must 30/03/06 CSA submit an application to vary the (2000) home’s registration category. 13(4) The Registered Person must 30/03/06 ensure that all risk assessments are regularly reviewed. 13(2) The Registered Person must 30/03/06 ensure that individual medication guidelines are accurate, clear and up to date. Regulation Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 23 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Powder Mill Lane,198 DS0000017386.V261291.R02.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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