Inspection on 16/02/06 for 4 & 6 Precinct Road

This inspection was carried out on 16th 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

4 & 6 Precinct Road 16/02/07

4 & 6 Precinct Road 13/01/05

4 & 6 Precinct Road 28/05/04

4 & 6 Precinct Road 10/10/03

4 & 6 Precinct Road 29/05/03

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 4 & 6 Precinct Road 4 & 6 Precinct Road, Coldharbour Lane Hayes Middlesex UB3 3AG Lead Inspector Ms Jean Bovell Unannounced Inspection 16th February 2006 11:30 4 & 6 Precinct Road DS0000027121.V278339.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 4 & 6 Precinct Road DS0000027121.V278339.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. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 4 & 6 Precinct Road Address 4 & 6 Precinct Road, Coldharbour Lane Hayes Middlesex UB3 3AG 020 8581 7351 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) h3m032ward@mencap.org.uk H4037@mencap.org.uk Royal Mencap Society Nicola Jayne Ward Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd July 2005 Brief Description of the Service: Precinct Road is a care home for five service users with learning disabilities. At the time of this inspection all the service users were male. The home consists of two interconnecting houses (No 4 & No 6) located in a residential area. Three service users occupy No 4 and two occupy No 6. Each house has a lounge, dining area, kitchen, bedrooms and a bathroom. The meals are cooked in No 4 and the laundry is in No 4. The home is close to shops and public transport. New Era Housing Association owns the premises and Mencap provides the care. The staffing level has to be high as the needs of the service users are high. No ancillary staff are employed at the home. The home aims to facilitate the service users to live as ordinary life as possible, to promote independence and to have access to all the external services they require. The service users attend day centres four days weekly. Three are members of clubs for people with learning disabilities. Leisure activities are provided in house and externally. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between 11.30 am and 3.30 pm on Thursday 16th February 2006. The Acting Manager, two members of the care support staff team and two service users were present. The Inspector was informed by the Acting Manager that three service users were attending the day centre and that the Registered Manager had taken up an Acting Service Manager’s post within the Organisation. During the course of the inspection records, policies and documents were viewed. A tour of the building was undertaken and observations were made. The requirements that were identified at the last inspection and the Standards that remained outstanding were examined. The Inspector spoke to two members of the care support staff team and two service users. One member of the care support staff team and the Acting Manager were cooperative and provided appropriate assistance throughout the inspection. What the service does well: The service users appeared appropriately dressed, well cared for and comfortable within their environment. Despite being non-verbal both service users indicated that they were happy at the home. Care workers who were on duty during the inspection were observed being attentive and competent in meeting the needs of the service users. The home’s policies and health and safety records were satisfactory and indicated that the best interests of the service users were being protected. Overall the home was found to be clean and hygienic. The atmosphere was lively and homely. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 4 & 6 Precinct Road DS0000027121.V278339.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 4 & 6 Precinct Road DS0000027121.V278339.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): 3, 4 and 5. Needs led assessment processes that involves visits to the home by prospective service users are satisfactorily undertaken prior to admission. The home’s contract/tenancy agreement is appropriately signed at the point of admission. Standards 1 and 2 were examined at the last inspection and the minimum requirements were met satisfactorily. EVIDENCE: The Acting Manager confirmed that prospective service users and relatives were invited to the home during an initial needs led assessment process and that written information on how specific assessed needs would be met was provided by the home. New service users were admitted on a three-month trial period after which a meeting was held to determine the suitability of the placement. It was evidenced on documents viewed that the home’s contact/tenancy agreement was signed by new service users or a relative/representative at the point of admission. 4 & 6 Precinct Road DS0000027121.V278339.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): 6,8, 9 and 10. Service users receive appropriate encouragement and support with making decisions and being independent, and confidentiality is respected. Care plans and risk assessments are properly undertaken but should be regularly reviewed. Standards 6 and 7 were examined at the last inspection and the minimum requirements were met satisfactorily. EVIDENCE: The Inspector was informed by the Acting Manager that service users were able to make decisions on various aspects of life within the home such as menu planning, indoor and outdoor activities and annual holidays. It was indicated on care plans examined that separate personal, social and health care needs had been assessed and risk assessments in relation to specific identified activities had been carried out. However, care plans were not regularly reviewed. The Acting Manager explained that a new system for 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 10 drawing up and reviewing care plans were in the process of being implemented. The home’s policy on Confidentiality was in place. Individual locks had been fitted onto service users bedroom doors and care support workers were observed to knock on doors prior to entering and interacted with service users in a sensitive and respectful manner. The Acting Manager confirmed that service users were able to receive confidential mail, personal telephone calls and meet privately with relatives/representatives within the home. 4 & 6 Precinct Road DS0000027121.V278339.R01.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): 11, 13, 14, 15, 16 and 17. Service users receive opportunities for personal development and are appropriately supported during activities at the home and within the community. Contact with relatives/representatives is encouraged and facilitated. Meals provided at the home are nutritionally adequate. Standard 12 was examined at the last inspection and the minimum requirements were met satisfactorily. EVIDENCE: The Acting Manager reported that service users received assistance with developing various skills including personal care, making drinks, assisting with meals preparation and shopping. It was reflected on records viewed that service users were involved daily activities in the community such as bowling, pub lunches, the cinema, walks, drives, bowling and day centre attendance. Annual holidays and day trips were also organised. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 12 A service user was taken for a pub lunch during the inspection. Indoor activities included bingo, karaoke and videos. A service user was observed participating in games with the Acting Manager at the beginning of the inspection and preparations were being made for a planned birthday celebration. Service users who were present at the time of the inspection appeared comfortable and relaxed. They moved freely around the home and interacted spontaneously with care workers who responded competently to their needs. A service user who answered the door to the Inspector was able to participate during a subsequent tour of the building. An open visiting policy is in operation at the home and contact with relatives/representatives are encouraged and facilitated. It was reflected on menus viewed that varied and nutritious meals were being served at the home. 4 & 6 Precinct Road DS0000027121.V278339.R01.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): 18 and 21. Service users receive sensitive and flexible support with personal care. Appropriate policies and procedures on terminal illness and death are in place. Standards 19 and 20 were examined at the last inspection and the minimum requirements were met satisfactorily. EVIDENCE: The Acting Manager confirmed that the service users required assistance, supervision or prompting with personal care. However, personal care tasks were undertaken in privacy within bedrooms or bathrooms and service users were able to choose what they wore. The home’s policies and procedures on terminal illness and death were in place. 4 & 6 Precinct Road DS0000027121.V278339.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): Standards 22 and 23 were examined at the last inspection and the minimum requirements were met satisfactorily. EVIDENCE: 4 & 6 Precinct Road DS0000027121.V278339.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 and 30. The home is clean, comfortable and adequately spacious for shared or individual activity. The bedrooms are personalised and the bathroom facilities are sufficient for meeting the needs of the service users. Specialist equipment is not currently required. Two requirements made under Standard 24 at the last inspection had not been met. EVIDENCE: The environment within the house was homely, comfortable and safe. The accommodation was adequately spacious and appropriate for shared or individual activity. The surrounding gardens were easily accessible to the service users. The service users bedrooms were viewed and were suitably furnished and fitted and reflected personal choices and interests. Although service users were not seen in their bedrooms during the inspection, the Acting Manager reported that service users were able to have private time in their individual bedrooms. The bathroom and toilet facilities were adequate and sufficient for meeting the personal and private needs of the service users. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 16 The Inspector was informed by the Acting Manager that there were no aids or adaptations at the home for assisting the service users as they were all ablebodied. The home was found to be clean and hygienic but two requirements made under Standard 24 at the last inspection relating to the maintenance of the garden and redecoration of the hallway and dining room had not been met. The Acting Manager confirmed that an application for funding the required work had been made to the Housing Association. 4 & 6 Precinct Road DS0000027121.V278339.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, 35 and 36. Staffing levels are satisfactory and care workers receive appropriate supervision and training for meeting the needs of the service users. A requirement made under Standard 35 at the last inspection had been complied with. EVIDENCE: Nine care support workers are employed at the home and it was reflected on the rota that a minimum of two care support staff members were on duty during waking hours and that there was one sleep-in and one waking staff cover at night. The home’s training programme was in place and indicated that appropriate staff training included moving and handling, epilepsy, challenging behaviour, infection control, fire safety and first aid. The Acting Manager reported that training on the protection of vulnerable was included within the induction and foundation training. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 18 Two care support workers have obtained National Vocational Qualifications in levels 2 and 3. In compliance with a requirement made under Standard 35 at the last inspection training on food hygiene had been delivered. A key worker system is operated at the home and care workers who were on duty during the inspection were observed being competent and attentive in meeting the needs of the service users. Regular staff supervision was provided at the home and was confirmed on records viewed during the inspection. 4 & 6 Precinct Road DS0000027121.V278339.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): 38, 39, 40, 41, 42 and 43. The ethos of the home is beneficial to the needs of the service users whose safety and welfare are being satisfactorily protected at the home. However, all documents should be confidentially filed within lockable cabinets. A requirement made under Standard 39 at the last inspection was met satisfactorily. EVIDENCE: The Inspector was informed by the Acting Manager that the home aimed to maintain a person centred and homely environment in which service users were encouraged to be independent. Mencap policies and procedures were in place. Daily records were being maintained in relation to the service users and incidents and accidents were appropriately recorded. However, a lock on the bottom drawer of a filing cabinet in which records were being kept was broken. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 20 Health and safety checks such as gas maintenance, water temperature, portable appliance testing, fire safety and emergency lighting were up to date. Environmental risk assessments had been undertaken. The Employers’ Liability Insurance Certificate and budget up to 17/01/06 were satisfactory. A Quality Assurance system had been put into place and complied with a requirement made under Standard 39 at the last inspection. 4 & 6 Precinct Road DS0000027121.V278339.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 X 2 X 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X 3 3 3 LIFESTYLES Standard No Score 11 2 12 X 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X 3 X 3 3 3 2 3 3 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 22 Yes 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 YA6 YA24 Regulation 15(2)(b) 23(2)(b) Requirement Timescale for action 01/04/06 3. YA24 23 (2)(O) 4. YA41 17(1)(b) The Registered person must ensure that service users care plans are regularly reviewed. House Number 6. The woodwork 01/07/06 in the dining room and the hallway must be redecorated. This is re-stated from the last inspection. Previous timescale 01/11/05. House Number 6.The garden to 01/07/06 the rear must be maintained and made accessible for service users. This is restated from the last inspection. Previous timescale 01/11/05 The Registered Person must 01/04/06 ensure that service users’ records are secured within lockable filing cabinets. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 23 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. Refer to Standard YA24 YA24 Good Practice Recommendations The carpet in the sleeping in room shoould be replaced. The office furniture should be replaced. 4 & 6 Precinct Road DS0000027121.V278339.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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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