Inspection on 16/02/07 for 4 & 6 Precinct Road

This inspection was carried out on 16th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

4 & 6 Precinct Road 16/02/06

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

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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 4 & 6 Precinct Road 4 & 6 Precinct Road, Coldharbour Lane Hayes Middlesex UB3 3AG Lead Inspector Ms Susan Woolnough-Singh Key Unannounced Inspection 16th February 2007 10:45 4 & 6 Precinct Road DS0000027121.V332046.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 4 & 6 Precinct Road DS0000027121.V332046.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. 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 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 H46013@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.V332046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 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.V332046.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Precinct Road. All of the Key National Minimum Standards for Younger Adults were assessed. The last key inspection took place on 16th February 2006. The Inspector received completed questionnaires from three service users and one Relative/Visitor. The Registered Manager completed an inspection questionnaire; some of the information contained in this has been used in this report. The Inspector toured the building and looked at the care files of service users and personnel files of new staff. A new Manger has been appointed to the home since the last inspection. She is in the process of submitting an application form to be registered with the Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? What they could do better: Some minor improvements need to be made to service user plans to ensure that review dates are clear. 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 6 The Manger must ensure that staff supervision is reviewed, and all staff have frequent supervision. The staff team are aware that work needs to be done to make the environment more homely. The Improvement Plan recognises this. 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. The summary of this inspection report can be made available in other formats on request. 4 & 6 Precinct Road DS0000027121.V332046.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 4 & 6 Precinct Road DS0000027121.V332046.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assessed prior to moving in to the home. EVIDENCE: The Service users group at Precinct Road have lived at the home for a number of years. There have been no new service users since the last inspection. MENCAP have clear procedures for the assessment and admission of service users to residential homes. Service Agreements/Contracts are available for service users these were not examined on this occasion. 4 & 6 Precinct Road DS0000027121.V332046.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users daily needs are reflected in the care plan. Service users are encouraged to make daily decisions with assistance. Good detailed risk assessments are in place to give service users the support they need to take risks. EVIDENCE: All service users have a care plan, three of these were examined, and a Personal Care Support Plan forms part of these. This is written in the ‘first person’ and describes precisely the support needed by service users in personal care and daily living. 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 10 Service users at Precinct Road live in two attached houses. In house number 6 service users need far more help with daily living and decision-making and choices are more limited. The three service users in house number four are more independent. One service user has made the decision that Precinct Road does not meet his needs and would like to move to supported living. The staff are working towards this. It is to be recommended that clear and manageable targets be set for this service user to enable him to work towards being considered for more independent living. This should form part of care plan. A very good range of risk assessments for service users are available these cover any behaviour that may need monitoring, tasks around the house and service users independence. Each file seen had a number of detailed risk assessments. 4 & 6 Precinct Road DS0000027121.V332046.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have the opportunity to attend a day service and participate in activities with staff. Service users use community facilities in the locality of the home and some have contact with their family. EVIDENCE: All service users attend a day centre, some on a part time basis. Service users usually have on day off each week, to carry out tasks in the home. The Inspector noted that service users had been reviewed at their day centre. Service users have links with their local community, this is usually for shopping and perhaps going to the local Pub or out for meal. One service user is able to 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 12 travel independently and on the day of the inspection went to the local shops alone. One service user has difficulty in going out, the Inspector was informed that recently he had been out more and this had been reasonably successful. The Inspector discussed with the Manager, service users contact with their families. Three service users have good contact with family including visits home. Service users daily routines during the week are based around the day centre they attend. All service users have their own bedroom where they are able to have privacy. The Inspector was at the home when service users returned from the day centre; on the whole they were able to choose how to spend the rest of the day. One service user was offered a meal out with a member of staff, as it was his Birthday. Service users in house Number 4 have access to the kitchen and are able to make small snacks. The service users in house Number 6 needs supervision in the kitchen at all times. Each house has a kitchen were staff cook for service users. Cooking is done on a small scale and meals are freshly cooked. 4 & 6 Precinct Road DS0000027121.V332046.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive the personal support they need. Health care support is available for service users as required. There are policies and procedures in place for the safe administration of medication. EVIDENCE: Good guidance and detail on the personal care required by service users is contained in the care plan, as described under standard 7. Some service users require more assistance than others in this area; therefore service users will have more privacy than others. All of the service users at Precinct Road require help, support and guidance with their health care. Service users are registered with a Local General 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 14 Practitioner, and will visit the surgery when needed. Service users receive home visits from a chiropodist if needed, although three service users have been registered recently with a NHS Chiropodist. A record of when service users have seen health care professions is kept on service users files. Referrals for additional health care are made as necessary for example psychiatric support. Service users do not administer their own medication. The Boots Monitored Dosage System is used for the administration of medication. One member of staff is designated the task of overseeing the medication system. A medication risk assessment and medication policy is in place. Medication storage and the medication administration record were seen. No concerns were noted with regard to these. 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 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 available for service users. Training and procedures are in place to highlight the importance of safeguarding vulnerable adults. EVIDENCE: A complaints procedure is available for service users. This also includes an audiotape. The written complaints procedure includes the contact details for CSCI. Guidance on the management of complaints is also available for staff. There have been no complaints made to Precinct Road since the last inspection. All staff have received training in Safeguarding Adults (POVA). The Manager was not sure, when asked if staff would know where to find the Whistle Blowing Policy, this was to be put on the Agenda for the next staff meeting. The MENCAP Induction workbook covers safeguarding adults material. Service users have different levels of support with their finances; this was discussed with the manager in some detail. The Manager said she audits service users financial records on a weekly basis. 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable environment; although both houses do need to be made more homely for the benefit of service users. EVIDENCE: Precinct Road comprises of two terraced houses. Three service users live in one house and two in the other. The Manager is working towards making the premises more homely. The lounge in House 6 has been attractively decorated and new furniture purchased. The Inspector had noted this as a real improvement since the last inspection. The rest of the house is clean and functional. Personal affects and ornaments are not on display in House 6 as service users are likely to remove them. House No.4 is clean and functional. An action plan dated 2007 has highlighted the need to purchase more homely items for both houses. In the inspectors opinion House No. 4 does require some work to meet the standard of providing a homely environment. The standard of hygiene and cleanliness was high in both houses. 4 & 6 Precinct Road DS0000027121.V332046.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. MENCAP offers staff the training to support service users in an effective manner. There is sufficient staff on duty to meet the basic needs of the service users. A recruitment policy is in place, which incorporates the required checks on staff and a good process of selection. Supervision and appraisal systems are in place to support staff in their work with service users. However, the regularity of supervision needs to be monitored. EVIDENCE: Information included on the Inspection Questionnaire states that staff have received training in Health and safety related subjects, Epilepsy, POVA, 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 18 medication, consent, and training on valuing service users. MENCAP offers staff a good induction programme; staff complete a workbook, which covers the knowledge and skills relevant to working with adults with a learning disability. Two support workers have NVQ and five support workers are currently working towards this. The staff team consists of the Manager, seven support workers and two night staff. A minimum of one member of staff is on duty at all times in each house. One member of staff sleeps in with one waking night staff on the premises. Staff recruitment policies and procedures are in place. The Inspector looked at the recruitment/personnel files of two new members of staff one of whom had transferred from another MENCAP home and had worked with the organisation for a number of years. Files contained all the relevant recruitment checks, including a CRB. Interview questions and notes could be seen on each file. A service Manager and Registered Manger form the interview panel. Both members of staff had had an appraisal. A supervision contract was in place. A supervision record for one member of staff was for September 2006 and February 2007. The second member of staff had received supervision although the supervision record was misplaced. 4 & 6 Precinct Road DS0000027121.V332046.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the skills and competence to administer the home in a competent manner. A monthly audit is in place for monitoring aspects of care and management in the home. Areas for improvement for the care of service users are identified. Practices are in place for the health and safety of service users and staff. EVIDENCE: The Manager was in the process of applying for registration with CSCI. She has worked as a Manager within a home for adults with a learning disability 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 20 within another organisation. The Manager has the GNVQ 2, NVQ 3 and is currently studying for an NVQ in Management. The Manager has to complete a monthly compliance report a sample of which was seen. This report is done in preparation for the Regulation 26 visit by the Service Manager. A number of checks are carried out on health and safety, service users health, staff, and financial systems. The Manager also prepares an Improvement Plan a copy of which was seen for January 2007. MENCAP has a number polices and procedures relating to health and safety. Monthly health checks are completed as part of the monthly compliance report. Support workers now have health and safety tasks delegated to them. The Manager supplied information on health and safety servicing of equipment in the Inspection Questionnaire. Checks of installations and equipment had taken place in 2006. The last fire drill had taken place in January 2007. The home had received a visit from the fire officer in September 2006. Service users files are kept in the office. They need to be kept in a locked cabinet, which they are not. 4 & 6 Precinct Road DS0000027121.V332046.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 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 2 25 x 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 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 3 x 3 X 3 X x 3 2 4 & 6 Precinct Road DS0000027121.V332046.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. 2. Standard YA6 YA24 Regulation 15 (2) (b) 23 (2) (a) Requirement Timescale for action 01/04/07 3. 4. YA36 YA41 18 (2) 17(1)(b) Service users care plans must be dated to indicate when they have been reviewed. Managers and staff must 01/05/07 continue to look at ways the environment can be improved and made more homely. The Manager must monitor the 01/04/07 level of one to one staff supervision in the home. The Registered Person must 01/05/07 ensure that service users’ records are secured within lockable filing cabinets. Timescale of 01/04/06 not met. 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 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 23 1. 2. YA6 YA23 The care plan of one service user should include information on clear targets to work towards independent and supported living. The Manager should endure that the Whistle Blowing Policy is accessible for staff. 4 & 6 Precinct Road DS0000027121.V332046.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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