Inspection on 20/05/05 for 225, London Road

This inspection was carried out on 20th May 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

225, London Road 14/06/07

225, London Road 16/11/06

225, London Road 29/06/06

225, London Road 26/01/06

225, London Road 02/12/04

225, London Road 30/07/04

225, London Road 16/01/04

Similar services:

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Edenvale

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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 18-65 225 London Road 225 London Road Twickenham Middlesex TW1 1ES Lead Inspector Simon Smith Unannounced 20 May 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. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service London Road, 225 Address 225 London Road Twickenham Middlesex TW1 1ES 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) 020 8892 6406 020 8892 6406 The Regard Partnership Limited Patricia McKeown Care Home 6 Category(ies) of Learning Disability (LD) registration, with number of places 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2.12.04 Brief Description of the Service: 225 London Road is home to six young adults with learning disability. The home is owned and managed by the Regard Partnership, an established provider of accommodation and specialist support to people with learning disabilities. The Statement of Purpose describes the service provided as follows: “225 London Road provides a specialist service for young adults with learning disabilities, some complex needs and challenging behaviours. There is an emphasis on independent living and supporting individuals to develop their social and interpersonal skills”. The home is situated within walking distance of Twickenham town centre, which provides a wide range of community facilities and good access to public transport networks. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 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 five residents, the manager and members of the staff team. A sample of records and staff files 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 had responded positively to the last CSCI inspection, taking action to ensure that Requirements made following that visit were met. The home met 25 of 30 Standards assessed at this inspection. Five Standards were almost met. The Home is committed to person-centred planning. The manager said that staff are looking for ways to help residents to become more involved in reviews and developing their care plans. Talking with residents confirmed that they are able to make decisions about their lives and that staff provide appropriate support and guidance where necessary. Residents are involved in the routines of the home and told the inspector that they participate in shopping, cleaning and maintain their own bedrooms and laundry. Residents also told the inspector that they plan the home’s menu and help with the house food shopping. Residents are involved in their local community and make use of shops, restaurants, pubs and cinemas, and have access to leisure activities such as bowling, cycling and swimming. Residents also attend day services, schools or colleges according to their preferences. Residents are registered with doctors locally and access community healthcare resources when needed. Care notes showed that ongoing healthcare conditions are managed well and that residents see specialists when they need to. The home has a Complaints procedure, which explains how people can complain and how the complaint will be investigated. No complaints have been made about the home since the last inspection. Staff are told how to recognise and prevent abuse of vulnerable people and the Regard Partnership has a procedure to help them voice any concerns they may have. The home is situated in a pleasant residential area and is close to local shops, banks, cafes, public transport and open spaces. Communal rooms were clean, welcoming and homely and residents’ rooms reflect their individual preferences. Action is needed to improve the appearance of the garden and the first floor window frames at the rear of the home. The manager is experienced and knows the home well. Staff are recruited according to written policies and are required to provide proof of identify and a 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 6 Criminal Records Bureau disclosure before starting work. New staff receive appropriate support and induction. All staff have access to regular training for the work they do. Staff also receive regular supervision, although the quality of these sessions must improve. The home must obtain and display an Employers Liability Insurance Certificate and make sure that all fire-fighting equipment is checked each year. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 7 contacting your local CSCI office. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 8 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 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 9 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) 1, 4 The home makes available clear information about the facilities and services it provides. Residents and their families/representatives are able to visit the home prior to admission to establish its suitability. 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. All prospective residents are afforded the opportunity to visit the Home prior to moving in. Admissions are made initially on a trial basis. A formal review is held at the conclusion of this period. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8 The home is committed to developing person-centred planning. The home aims to involve residents in their reviews. Residents are consulted about decisions that affect them. Residents are involved in the daily life of the home. Residents must be registered on the electoral roll. EVIDENCE: An individual plan of care is in place for each resident. The home is committed to the concept of person-centred planning. A senior support worker attended day one of a four day introduction to the principles of person-centred planning on the day of inspection and the manager plans to attend person-centred planning training July. The manager advised that the home has also liaised with the local authority in the development of person-centred planning. The local authority person-centred planning co-ordinator recently visited the home to speak to staff at a team meeting. The home is also aiming to increase residents’ involvement in their care plans and reviews. One service user 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 11 informed the inspector that she had been able to contribute to her recent review. Discussion with residents confirmed that they are able to make decisions about their lives and receive support from staff to do so where necessary. Residents’ views are sought by staff on all aspects of life at the home and their participation in the routines of daily living is encouraged. Residents informed the inspector that they participate in housework, shopping and cooking and are responsible for the upkeep of their rooms. The manager advised that residents are not currently registered to vote. The home must ensure that residents are able to exercise their right to vote should they wish to do so. See Requirement 1. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15, 17 Residents are supported to develop independent living skills. Residents are active in their local community. Residents participate in a range of activities appropriate to their needs and wishes. Residents are supported to maintain relationships with their families and friends. The home’s menu is varied, well balanced and takes account of residents’ preferences. EVIDENCE: Residents are encouraged to develop the skills required for independent living and receive support from staff in this area where necessary. A number of residents made drinks and snacks with support from staff during the 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 13 inspection. 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 advertised menu indicated that the home provides a varied and well-balanced diet. Residents are encouraged to contribute to menu planning. Staff advised that alternatives to the planned menu are available where required. The Statement of Purpose reports that the home is able to cater for specific dietary needs where needed. One resident advised the inspector that he enjoys going out for lunch one day each week. Residents make much use of community resources and facilities locally, including shops, restaurants, pubs and cinemas, and have the opportunity to participate in a range of leisure activities such as bowling, cycling and swimming. Residents also attend day services, schools or colleges according to their preferences. One resident attended college on the day of inspection. All residents are able to take at least one holiday each year. Residents are supported to maintain relationships with their friends and families and the majority have regular contact with family members. Residents are encouraged to receive visitors and staff reported that the Home encourages service users to receive visitors at any time. The views and input of service users’ representatives are also sought at reviews. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20 Residents’ privacy and dignity are maintained Service users are supported to access specialist healthcare resources where necessary. Staff liaise effectively with healthcare professionals regarding the care of residents. The storage and recording of medication was satisfactory. EVIDENCE: Staff maintained the privacy and dignity of residents throughout the inspection and personal care needs were met appropriately. Staff knocked before entering private accommodation and addressed residents with respect. Residents were afforded sufficient time to complete tasks at their own pace and decisions to spend time alone were respected. All residents are registered with local general practitioners and access other community healthcare resources as necessary. The home is required to manage some ongoing healthcare conditions experienced by residents, such as epilepsy. Inspection confirmed that these conditions are managed well and 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 15 that the home provides appropriate support to residents and staff. For example an epilepsy specialist visits the home regularly to monitor residents affected by the condition. Staff provide the specialist with recorded details of seizures in order to assist the monitoring process. A care plan addressing the issue is developed and written guidelines put in place for staff. The community nurse also visits the home to provide training for staff in effective management of the condition. The system used for the administration of medication is appropriate. Medication was stored and labelled appropriately at the time of inspection. All medication coming into or leaving the Home is recorded. All homely remedies are prescribed by general practitioners before being administered by the Home. Inspection of medication records for two residents revealed no omissions or errors. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 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 standard(s) 22, 23 Residents and other stakeholders are able to register any concerns or complaints through a formal procedure. Guidance is provided for staff in the recognition, prevention and reporting of abuse. EVIDENCE: The home has an appropriate Complaints procedure, which specifies timescales for action and response. A ‘Speaking Up’ form is available to residents should they wish to register a complaint. No complaints have been made about the home since the last inspection. The home works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’. This document provides clear definitions of what constitutes abuse and guidelines for staff in the recognition and reporting of abuse. One member of staff has been dismissed and referred for inclusion on the Protection of Vulnerable Adults (POVA) list in the last twelve months. The manager advised that all staff have attended Protection of Vulnerable Adults training in the last twelve months. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27, 28, 30 Communal and private rooms are comfortable, homely and reflect the preferences of service users. Toilets and bathrooms are accessible and provide sufficient privacy. The Home is clean and hygienic. Improvements are required in some areas to maintain the appearance of the home and garden. EVIDENCE: The home is situated within walking distance of Twickenham town centre, which provides a wide range of community facilities and good access to public transport networks. Communal rooms include a lounge, conservatory/dining area and kitchen. A new kitchen had been installed since last inspection. All areas of the Home were clean and hygienic at the time of inspection. The home has a large rear garden, which was overgrown in some areas. The manager advised that contractors will be employed to clear the garden in the 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 18 near future and that the patio area will be properly levelled. Several residents spent time in the garden during the inspection and it is clearly a valued resource. The manager reported that, once the garden is manageable, it is hoped that residents and staff will maintain the area. Items left behind following the installation of the storage shed need to be removed. See Requirement 2. Residents’ bedrooms are situated on both the ground floor and first floor of the home. One resident showed the inspector his room, which had been recently redecorated. The resident confirmed that he had chosen the colour scheme and decorations and that he was pleased with the outcome. Another resident showed the inspector her room, where she was spending time talking with a member of staff. The paintwork on first floor window frames to the rear of the property was flaky and needs repainting. The manager reported that the Regard Partnership is considering replacing these windows. See Requirement 3. Toilet and bathroom facilities are accessible and are available on the ground floor and first floor of the home. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 19 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, 34, 35, 36 Staff have an awareness of their own and one another’s’ roles. Staff are appointed following an appropriate recruitment and selection procedure. New staff receive an induction to the organisation and to the home. Staff have access to training appropriate to their roles. The quality of recording of supervision sessions must improve. EVIDENCE: The Home has a clear staffing and management structure. Job descriptions are in place for all posts within the staff team. All new starters participate in both a corporate induction and local introduction to the home. Staff are able to access regular training opportunities provided by the Regard Partnership and the manager advised that the home has an allocated training budget. Handovers are given by staff finishing their shift to those beginning work. The inspector was able to sit in on handover between shifts and observed that staff beginning work are well briefed on events at the home before starting their 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 20 shift. A communication book and house diary are maintained. Team meetings are held on a regular basis. Two staff files were examined. Both contained appropriate Criminal Records Bureau disclosures, two references and proof of identify. Records demonstrated that an appropriate recruitment procedure had been followed prior to their appointment. Files provided evidence of supervision but the quality of recording of these sessions was poor. To fully realise benefits, supervision notes should clearly record items discussed and actions agreed. This was discussed with the manager, who agreed to examine ways of improving this area. See Requirement 4. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 21 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) 38, 40, 41, 42 The home has a committed and experienced manager. Staff work within defined guidelines and a clear procedural framework. Appropriate liability insurance must be obtained. Fire fighting appliances must be checked annually. EVIDENCE: The manager demonstrated a good awareness of the needs of residents and a positive approach to the inspection process. The manager has access to senior management support and the area manager visits the home weekly. Staff work within defined guidelines according to the policies and procedures developed by the Regard Partnership, which underpin the values and working practices of the home. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 22 The Certificate of Employers Liability Insurance displayed in the home had expired. See Requirement 5. The home has an appropriate fire detection system. Clear instructions in the event of a fire were prominently displayed. The kitchen is equipped with a fire blanket and extinguisher. The sample of fire extinguishers examined had been checked in April 2004 and needed annual inspection. See Requirement 6. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 23 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 x x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 x x 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 225 London Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x 3 x 2 2 G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 24 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. 2. Standard 7 24 Regulation 12(4) 23(2)(o) Requirement Residents must be registered on the electoral roll. Clear the overgrown areas of the garden. Remove debris left following the installation of the shed. Repaint or replace the first floor window frames at the rear of the home. Improve the quality of recording of supervision sessions. Demonstrate that the home has valid Employers Liability insurance. Demonstrate that all fire-fighting appliances are checked annually by an appropriately qualified individual. Timescale for action 30.08.05 30.07.05 3. 4. 5. 6. 24 36 41 42 23(2)(b) 18(1)(2) 25(2)(e) 23(4) (c)(v) 30.08.05 30.07.05 30.07.05 30.07.05 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. 225 London Road G54-G04 S17380 London Rd 225 V227894 200505 Stage 4.doc Version 1.30 Page 25 Refer to Standard Good Practice Recommendations 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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