Inspection on 19/01/06 for 26, Cross Street

This inspection was carried out on 19th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

26, Cross Street 09/11/06

26, Cross Street 25/08/05

26, Cross Street 18/11/04

26, Cross Street 25/05/04

26, Cross Street 13/01/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Cross Street, 26 26 Cross Street Hampton Hill Middlesex TW12 1RT Lead Inspector Sandy Patrick Unannounced Inspection 19th January 2006 10:00 Cross Street, 26 DS0000017360.V261212.R01.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 Cross Street, 26 DS0000017360.V261212.R01.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. Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cross Street, 26 Address 26 Cross Street Hampton Hill Middlesex TW12 1RT 020 8783 0973 020 8783 0973 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) London Borough of Richmond upon Thames Mr James Edward King Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th August 2005 Brief Description of the Service: 26 Cross Street is a care home providing personal care and accommodation for up to four service users who have a learning disability and sensory impairments. The building is owned by London Quadrant Housing Association. The service is run and managed by the London Borough of Richmond. The home is a bungalow situated in Hampton Hill. It is close to local shops, pubs, community facilities and public transport links. Bushey Park is within walking distance. All bedrooms are for single occupancy. The internal layout of the building and the service provision are designed to meet the needs of people who have a sensory disability. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 19th January 2006 and was unannounced. The Inspector met with two of the service users, the Deputy Manager and other staff on duty and was made welcome by all. The atmosphere was relaxed and like a family home, with service users and staff sharing activities, feelings and jokes. There is a genuine fondness and trust between service users and staff. Sadly one service user passed away at the end of 2005. Everyone at the home clearly missed their friend. Those at the home on the day of the inspection expressed their shared grief and feelings of loss, but also showed how they remembered him fondly through their everyday activities. The Inspector was invited to join the service users and staff for lunch. This was freshly made, well prepared and tasty. The meal was an enjoyable social occasion. What the service does well: What has improved since the last inspection? Service users have made individual achievements. The service users have enjoyed a number of day trips, holidays and social events. The staff team have consistently shown a strong dedication to caring for each individual and providing the service that each person wants and needs. Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 6 Requirements made at the last inspection visit have been met. 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. Cross Street, 26 DS0000017360.V261212.R01.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 Cross Street, 26 DS0000017360.V261212.R01.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&3 Service users have contributed to and have access to information about the services and facilities offered to them. The needs of service users are met and they are happy living at the home. EVIDENCE: Service users and staff at the home have created an attractive and informative guide to the home. The Manager has developed a Statement of Purpose. Neither of these documents has changed since the last inspection. The needs of service users are varied and some service users have complex health care needs. The staff are appropriately trained and work with other health care professionals to make sure that needs are met. Staff are trained in a variety of communication techniques which help service users to understand them. Cross Street, 26 DS0000017360.V261212.R01.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 Individual needs are appropriately recorded within service user plans and a range of guidelines and risk assessments. EVIDENCE: Individual service user plans are in place for all service users and they have participated in making these. Plans are updated monthly. Service users and their keyworkers make objectives for the coming month. Staff record how these objectives are met. There is a range of risk assessments in place to make sure service users can take supported risks. These are regularly reviewed. Throughout this and previous inspections, the Inspector saw examples of staff sharing information with service users, consulting them and offering choices. Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 10 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): 11, 12, 13, 14, 16 & 17 Service users develop and maintain interpersonal skills in a relaxed and comfortable environment. Individual needs and aspirations are met. Service users participate in a range of leisure and educational activities designed to meet their needs and help them pursue interests. Service users chose and help to prepare a range of healthy and nutritious food. EVIDENCE: Throughout the inspection, and at previous inspections, the atmosphere at the home was warm and relaxed. Service users and staff respected each other and shared their feelings and experiences. Service users are included in all decision making and are consulted about the running of the home. Service users participate in household jobs and cooking. Their contributions are a natural part of life at the home, and are valued and seen as essential. On the day of the inspection, one service user helped to prepare the lunch and Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 11 the other service user helped with the household shopping, laundry and recycling. Service users have a range of activities, which they enjoy and have chosen. These include accessing local colleges, resource centres and community facilities. Some of the activities are planned and structured, however service users suggest and take part in activities on an ad hoc basis. Service users enjoy accompanying staff on trips to local shops and use parks and other community resources when they chose to. Some of the service users have taken short holidays and have taken part in a number of day trips and social events. They told the Inspector that they had enjoyed these. Service users were proud of their achievements and wanted to show the Inspector photographs, pictures and personal accounts of the things that they had done. All the food at the home is freshly prepared. Service users have been supported to understand about healthy diets and are involved in the planning and preparation of all food. Service users and staff have an understanding that diet has a direct impact on emotional and physical wellbeing. Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 12 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 & 21 Personal and health care needs are recorded. Staff have an excellent understanding of these and have worked hard to make sure service users understand their own needs and are empowered. There are appropriate procedures regarding medication and these are followed. The staff and service users have worked hard to support a service user to live through an illness and die at the home as they wished to. EVIDENCE: Personal care needs are clearly detailed in service user plans. Service users are supported to maintain as much independence as possible. The health care needs of some of the service users have changed over recent months. Staff have worked alongside health care professionals to support service users so that their needs are fully met. The staff are really dedicated to making sure service users are healthy and that they understand their own health needs. The staff have an excellent knowledge of needs and have gone beyond the call of their duties to meet these. The Manager and staff have advocated on behalf of service users and have empowered them to make their own decisions about their health care. Their hard work in this area is highly commendable and is reflected in the successes and achievements for service Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 13 users. The service users who feel supported and empowered by staff have been able to take a lead in making positive changes to improve health. One service user spent some time in hospital during 2005. The staff from the home visited and supported this service user at the hospital so that they could get better and return home sooner. Medication is appropriately stored, recorded and administered. There is a suitable procedure regarding medication and all staff have been trained in this area. Sadly one of the service users passed away at the end of 2005 following an illness. The staff and other service users all worked hard together to make sure that this service user remained and died at home. The service users spoke about this experience and how they had spent time sitting with their friend. Health care professionals who worked with the home praised the way in which staff had supported this service user. The pain and grief that the staff and other service users felt at the loss of this person were obvious. However, they have supported each other and thought of how to remember their friend in positive ways. The service users and staff spoke about the funeral and how they had all contributed to the organisation of this. One service user showed the Inspector a book of remembrance they had all created, which celebrated their friend’s successes and captured some of the memories they all shared. The work and dedication of staff to support the service users and each other through this difficult time is highly commendable and just one indicator of the depth of affection and understanding that is part of this home. Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 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 There are appropriate procedures regarding vulnerable adults and whistle blowing. EVIDENCE: There is an appropriate complaints procedure, detailing timescales and information about the Commission for Social Care Inspection. There is information about the complaints procedure in the Service User Guide. There have been no complaints at the home in the past year. There is a record of compliments made about the work of the staff team from other professionals who work with service users. The London Borough of Richmond has produced procedures for the Protection of Vulnerable Adults, Recognising Abuse and Whistle Blowing. All staff receive training in recognising and reporting abuse. complaints, protection of Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 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, 26, 27, 28, 29 & 30 Service users live in a comfortable, well maintained and suitable environment. Adaptations have been made to ensure that service users’ needs can be met. EVIDENCE: Accommodation is provided on one level and is designed to ensure accessibility for service users. The building is well maintained and is attractively decorated throughout. Bedrooms and communal areas have been personalised by service users. Bright contrasting colours support orientation. The home has a very attractive and well maintained garden, which has been landscaped by staff. Staff have build a covered area and barbeque and a number of original features. Flowers, photographs, pictures and personal ornaments add to the general ambience. Bedrooms are for single occupancy and are appropriately furnished and equipped. Service users have personalised their rooms and communal areas. The home has been designed to meet the needs of people with sensory disabilities. The layout of the home allows freedom of access. To support orientation furniture is never moved or rearranged. Staff make regular checks to ensure that all corridors and floors are free from potential hazards. Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 16 Corridors are equipped with handrails. The bathroom has been equipped with a walk in shower and specialist bath. The home was clean and tidy throughout on the day of the inspection. There are appropriate procedures for infection control, Control of Substances Hazardous to Health and laundering of clothes. Cross Street, 26 DS0000017360.V261212.R01.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 & 35 Staff are appropriately employed sufficient number and are trained and supported. The staff team have a good understanding of their roles and responsibilities. EVIDENCE: All staff have job descriptions and there is a range of information on roles and responsibilities, including a guidance file for new and temporary staff. Regular team meetings and individual supervision take place and are recorded. The staff have consistently told the Inspector that they are well supported both formally and informally. The atmosphere at the home is supportive and understanding. Service users, management and staff talk about their feelings and experiences and genuinely care about one another, offering support and sense of community. There are systems to make sure that the needs of the service are met on a daily basis and so that all staff know their allocated responsibilities. However, the procedures are flexible and allow the home to run in a natural way. There is a planned programme of training and support for staff to undertake NVQ qualifications. Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 18 There is an appropriate procedure for the recruitment of staff. No new staff have been employed since the last inspection. Some of the staff have worked with the service users for many years. Cross Street, 26 DS0000017360.V261212.R01.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): 37, 38 & 42 The service is well managed and service users and staff are able to contribute to the running of the home. Appropriate checks on health and safety are made and recorded. EVIDENCE: The Manager is appropriately qualified and experienced. He has managed the home since it opened. Since this time he has developed the service and participated in relevant training. The Deputy Manager praised the Manager for his approach and management style. He also told the Inspector of examples where the Manager had advocated on behalf of service users and challenged other professionals so that the rights and choices of service users were respected. The staff team are obviously close and work well together. Staff on duty praised managerial support and each other. One member of staff told the Inspector that the Manager was ‘wonderful’ and very supportive. Individual Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 Page 20 members of staff have made positive achievements whilst supporting service users and their work is recognised and appreciated by the Manager and Deputy Manager. The Deputy Manager was keen to tell the Inspector about the hard work of staff and how this had directly improved the lives of service users. Staff are able to contribute their ideas and opinions and they said that they felt listened to. The management style is inclusive and service users and staff are consulted about all aspects of the home. There are regular checks on health and safety at the home. Individual fire risk assessments are in place and there was evidence of regular fire checks and drills. Cross Street, 26 DS0000017360.V261212.R01.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 X 3 3 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 4 3 4 X X X 3 X Cross Street, 26 DS0000017360.V261212.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action 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 Cross Street, 26 DS0000017360.V261212.R01.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 Cross Street, 26 DS0000017360.V261212.R01.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. 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!