Inspection on 23/10/06 for 246 Haymill Close

This inspection was carried out on 23rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

246 Haymill Close 30/01/06

246 Haymill Close 09/09/05

246 Haymill Close 24/02/05

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 18-65 246 Haymill Close Greenford Middlesex UB6 8EL Lead Inspector Emma Dove Key Unannounced Inspection 23rd October 2006 13:40 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 246 Haymill Close Address Greenford Middlesex UB6 8EL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8810 6699 020 8810 8104 hm246haymill@ealing.org.uk Ealing Consortium Limited Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: 246 Haymill Close is a care home providing personal care and accommodation for seven adults with learning/physical disability. Six people are currently living at the home. The home is owned by a housing association and managed by the organisation Ealing Consortium, who manage a number of similar registered services in the local area. The home was purpose built in 1995 and is modern and spacious. All bedrooms are single, with four on the ground floor and three on the first floor. There are sufficient bathrooms, with appropriate adaptations to meet the complex needs of service users. There is a lounge, separate dining room and kitchen on the ground floor. There is a large garden to the rear and side of the home, which comprises of a patio area, lawn and shrubs. The home is on a residential housing estate, next door to the Ealing Consortiums activity resource centre. The home is linked by a corridor with another separately registered home. The home is close to the A40, which is a main road into London. In addition it is a short walk to a main road, where there is public transport to the local towns of Greenford and Ealing Broadway. Information about the CSCI is available at the home for residents and their representatives. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over three and a half hours on the afternoon of the 23rd October 2006 by one regulation inspector. The inspection included speaking with residents and staff, the inspection of communal areas, two bedrooms and examining records. Six questionnaires were sent to relatives, professionals and staff at the home. No questionnaires have been received by the CSCI. What the service does well: What has improved since the last inspection? What they could do better: Case files must contain up to date information on residents cultural and religious needs, so that staff can meet these needs. The monthly reports must be completed as set out by the organisation, to follow procedures and keep residents information up to date and in good order. Records should be maintained detailing how residents choose meals. The count of medication must confirm that medication has been administered as per instructions, to ensure residents health needs are fully met. A decision should be made regarding which bedroom one resident uses, and their belongings moved into the room. One previous residents belongings must be moved to more appropriate storage. Staff vacancies should be filled to provide consistency of care and stability to residents. A manager must be appointed and registered with the CSCI. The gas safety, electrical supply and portable electrical appliances must be checked and tested at the required intervals to ensure service users and staffs health and safety is maintained at all times. The hoists must be repaired or replaced with evidence available at the home confirming repairs are completed. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 6 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. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed assessments are completed prior to and on admission to the home. Prospective residents are invited to visit the home before they move in. EVIDENCE: Case files contained detailed assessments completed prior to and on admission to the home, ensuring that the individuals needs are known and can be met. A personalised induction process is developed for each new resident, to best meet the individuals needs. The induction process includes staff visiting the prospective resident, visits to the home to meet other residents and staff and spending time getting to ‘know’ and ‘get the feel’ before deciding if it is right for them. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 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, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Case files contain detailed information of residents needs, ensuring staff have access to this information. However some records require updating to fully reflect individuals needs. EVIDENCE: Case files contain detailed information of residents needs, which is important to ensure staff are able to meet individuals complex health and social needs. Care plans were in place and have been reviewed on a regular basis. One case file contained a planning book, which is a person centred plan and includes a care needs assessment, health information and aims for the year. A number of one individual’s aims for the year had not been met, staff reported that this was due to the individual’s changing health needs. Residents religious and cultural needs are recorded so they can be met by staff. One individual’s cultural and religious information needs updating to reflect their current level of involvement. Staff write a monthly report detailing activities the individual has participated in, including any medical appointments and health information. These reports 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 10 are used to inform reviews and document changes. In two case files examined these reports had not been completed for three and seven months. This does not follow the organisation’s procedures and does not keep residents information up to date and in good order. Staff reported that they support residents to make decisions and choices regarding their every day activities, food and clothing, to the individuals ability. It takes time for staff to get to know individual residents likes and dislikes and ways they communicate their wishes. This identifies the importance of the detailed records to ensure staff can support individuals with making choices. Risk assessments are in place and staff reported that they are used to minimise risks for individuals. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 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 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a variety of social and leisure activities to meet their needs. Contact with family members and friends is supported. Residents are offered a varied menu. EVIDENCE: Residents have access to the activity resource centre which is close to the home and provides specialist support for individuals. Staff reported that residents also spend time at the home and attend community based activities. Two residents spent the afternoon of the inspection resting on their beds before being woken for their evening meal, no activities were taking place. One resident was on holiday at the time of inspection. Staff reported that the individual had chosen the holiday and was being supported by two members of staff. One resident part owns a car to enable access to community facilities with staff support. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 12 Staff reported that residents are supported to maintain contact with relatives and friends. The home follows a menu which has been devised by the cook in consultation with a dietician, it is not clear how residents are involved with choosing the food they eat. The meal observed was appropriately prepared and smelled appetising although the inspector left before the meal was served to receive comments from residents. One resident was looking forward to dinner. Staff reported that any cultural, religious and medical dietary requirements are met by the menu provided. A record of food is maintained for individual residents which enables staff to monitor their eating and address concerns with medical professionals as required, however the records examined had not been completed in full. Records have been maintained of fridge and freezer temperatures almost every day, which was a Requirement at the last inspection. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 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): 18, 19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents health care needs are well documented so they can be met with the exception of some medication recording. EVIDENCE: Staff support residents with personal care tasks and reported that they are aware of individuals needs and how to meet them. Case files contain detailed information of individuals health needs and how they should be met. Staff confirmed that they are supported to meet residents health needs and have access to various health professionals for training purposes, advice and general information. Medication is appropriately stored, labelled and recorded with the exception of one medication for one resident where the count of medication at the home and the amount which should have been taken did not tally, with too few tablets remaining. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 14 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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clear complaints procedure is in place which is available to residents and their representatives. Policies and procedures regarding the protection of vulnerable adults are in place. EVIDENCE: The organisation has a complaints procedure which is available to residents and their representatives. It is difficult to ascertain residents understanding of this policy and how they would make a complaint, although staff demonstrated detailed knowledge of individuals needs and changes in behaviour which may be caused by problems. The complaints record was not available for inspection, due to their being no senior staff on duty at the time of the visit. Staff were not aware of any complaints. The CSCI have not received any complaints since the last inspection of the home in January 2006. Staff reported that they complete training in the protection of vulnerable adults and are aware of issues regarding abuse. A random examination of residents finances noted that they are securely stored and checked daily by staff. Records were well maintained and the balance and the total were correct. The inspector noted that for one resident, money was spent on personal items and lunch for both the resident and the member of staff. Staff reported that the money spent on staff will be reimbursed when a senior member of staff is next at the home. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 15 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, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable environment which is maintained to a satisfactory standard. Bedrooms are single, sufficient communal areas and bathrooms and toilets are provided. All areas of the home were clean. EVIDENCE: The home was purpose built over ten years ago and was designed to meet residents needs, with aids and adaptations fitted in bathrooms and hoists provided for individuals. Bedrooms are single and two were seen to have been personalised to the individuals wishes, although one resident was currently in a different room and some of their belongings were still in their previous room. A decision should be made as to which bedroom the resident will be in and their belongings should all be in that room. Also a number of items from a previous resident should be stored more appropriately than in a bedroom. A separate lounge and dining room are available for residents and one bedroom and the lounge have doors to the garden. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 16 The loft hatch on the first floor was open, which will allow a draft. Two carpets had stains which need cleaning or replacing, otherwise all areas of the home seen were clean and free from unpleasant odours. Appropriate policies and procedures are in place for the prevention of infection control. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 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): 32, 33, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels were observed to be appropriate during the course of the inspection, although a high number of agency staff are covering vacant posts. Staff have access to training and development. EVIDENCE: The published staffing rota noted three members of staff on duty in the morning and the afternoon. One member of staff is awake and one member of staff asleep but on call at the home at night, shared with a neighbouring registered home managed by the organisation. The manager left the home mid October 2006 and two senior staff are currently covering the management duties with support from other homes managed by the organisation. In addition there are five vacant posts for two night staff, one senior member of staff and two support staff. Staff reported that the agency staff used are regular and have completed an induction to the home and know the residents and how to meet their needs. Agency staff confirmed that they had been given an induction to the home and to the residents and how to meet their individual needs. Staff have access to appropriate training and development sessions through the organisation. Staff have completed training in fire safety, health and 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 18 safety, epilepsy, food hygiene, manual handling, bereavement and managing PEGG feeding. All staff complete the learning disability award framework training (LDAF). Staff reported that senior staff are currently giving all staff supervision, although it was not clear if regular agency staff are receiving supervision. Staff reported that they feel supported within their work to carry out the necessary tasks. The inspector was not able to access staff files at this visit. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 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): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Two senior staff are covering the managers post with support from other senior staff within the organisation. The quality assurance system could be developed further to ascertain residents, their representatives and visiting professionals opinions of the services provided. Health and safety policies are in place, however some recording practices does not ensure residents and staffs health and safety is maintained. EVIDENCE: As previously noted, the manager left recently, staff reported that an advert to fill the post has been placed within the organisation and that the closing date had passed, although staff were not aware of progress with this. Staff meetings are held every two weeks with minutes available. Staff reported that they discuss residents progress and changes in need at meetings. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 20 A representative from the organisation visits the home every month to monitor the quality of care provided at the home. A copy of the report from these visits is available at the home. Changes have been made to the quality assurance checklist which looks at the day-to-day running of the home. Consideration should be given to seeking the opinions of residents, their representatives and professionals who visit the home. Health and safety policies and procedures are in place. Records are maintained of hot water temperatures, which are within the recommended range. The hoists have been serviced, the record for one hoist noted that the casing was cracked and needs to be replaced. It was not clear whether this had been completed. The record for another hoist indicated that it was not working. Staff reported that this was not causing problems, but it should be repaired. The fire alarm has been serviced and weekly tests carried out except in February and April 2006. Four fire drills have been held with records maintained. The portable electrical appliances were due to be tested in December 2005, staff reported that this had been carried out although the certificate was not available to confirm this. The electrical supply was tested in 2000 and this needs re-doing. The gas safety certificate was dated 7th June 2005, this test must be completed every year with the certificate at the home. Staff complete a health and safety check of the home every month with any actions noted. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 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 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 22 NO 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 YA6 Regulation 15 (1) Requirement The registered person must ensure that one residents religious information is updated to reflect changes. The registered person must ensure that medication is administered and records of medication taken tally with the amount left in packets. The registered person must ensure that two stained carpets are cleaned or replaced. The registered person must ensure that sufficient staff are employed at the home to meet residents needs. The registered person must ensure that information regarding staff recruitment is maintained at the home. The registered person must appoint a manager who registers with the CSCI. The registered person must ensure that the broken/damaged hoists are repaired or replaced. The registered person must ensure that the electrical supply, portable electrical appliances and gas safety checks are carried out DS0000058136.V310940.R01.S.doc Timescale for action 18/12/06 2. YA20 13 (2) 18/12/06 3. 4. YA30 YA32 23 (2) d 18 (1) b 18/12/06 18/12/06 5. YA34 17 (2) Sch 4 (6) 8 (1) & (2) 23 (2) n 13 18/12/06 6. 7. 8. YA37 18/12/06 18/12/06 18/12/06 YA42 YA42 246 Haymill Close Version 5.2 Page 23 at the required intervals. 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. 2. 3. Refer to Standard YA6 YA17 YA26 Good Practice Recommendations The registered person should ensure that staff complete monthly reports following the organisations procedures. The registered person should give consideration to recording how residents choose their meals and complete more detailed record of food eaten. The registered person should ensure that one previous residents belongings are appropriately stored and that another resident has all of their belongings in their bedroom. 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 246 Haymill Close DS0000058136.V310940.R01.S.doc Version 5.2 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!