Inspection on 22/08/06 for 45a, Hampton Road

This inspection was carried out on 22nd August 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 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

45a, Hampton Road 19/01/06

45a, Hampton Road 31/08/05

45a, Hampton Road 07/12/04

45a, Hampton Road 09/07/04

45a, Hampton Road 06/02/04

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 45a, Hampton Road Teddington Middlesex TW11 0LA Lead Inspector Simon Smith Unannounced Inspection 22nd August 2006 2:30 45a, Hampton Road DS0000017368.V309949.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 45a, Hampton Road DS0000017368.V309949.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. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 45a, Hampton Road Address Teddington Middlesex TW11 0LA 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 8977 5406 020 8977 5406 hampton.road@unitedresponse.org.uk None United Response Mrs Jacqueline Mary MacKinney Care Home 5 Category(ies) of Learning disability (5), Physical disability (2) registration, with number of places 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can accommodate one named service user over 65 years of age. 19th January 2006 Date of last inspection Brief Description of the Service: The home was opened in 1996 and is registered with the CSCI to accommodate a maximum of five adults with learning disabilities, two of whom may have physical disabilities. The property is owned and maintained by Thames Valley Housing Association. The service is managed by United Response, a not-for-profit provider of community services for people with learning disabilities. The home’s fees currently range from £1247.42 to 1279.52 per week. The home benefits from proximity to public transport networks and good shopping and community facilities. A high standard of decoration has been achieved throughout and the property has a well-maintained garden. The aim of the service is to provide a safe, comfortable environment, with a homely and inclusive atmosphere, where the client groups needs are accommodated as fully as possible. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector used evidence from a wide range of sources when making judgements about the home. These included a visit to the home and discussion with residents, the manager, deputy manager and staff. A sample of records was examined, including staff and residents’ files. The inspector was made welcome during the visit and wishes to thank residents, staff and all those who gave their views about the home. The home met 27 of 31 National Minimum Standards assessed at this visit. Four Standards were exceeded. The inspection was a positive one, providing evidence that residents receive high quality, individualised care from staff who know their needs well. Staff are committed to involving residents in the life of the home and make use of their knowledge and experience of residents to provide appropriate support in decision making. Residents are able to have privacy when they want it and staff talked to residents with respect during the inspection. Residents’ preferences about the care they receive are recorded and known by staff. Surveys were given to residents, relatives, staff and professionals who visit the home. Residents received support from their keyworkers to complete and return surveys. Relatives reported that they are made welcome by staff when they visit and that they are kept informed of important issues affecting their family member. Staff said that they receive good support to do their jobs, including an induction when they start work, regular supervision and training opportunities. When asked to identify what the home does well, one member of staff said, “everyone works well towards the same objective – looking after the clients”, whilst another said that the home “supports service users to live their lives as they wish”. What the service does well: Promotes person-centred planning and provides good support for residents to lead individual lives. Responds well to any changes in residents’ needs. Promotes and supports residents’ participation in their community. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 6 Supports residents to develop and maintain positive relationships with their friends and families. Provides a well balanced diet that meets a wide range of nutritional needs. Provides a stable and committed staff team. Provides a skilled and experienced manager. 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. 45a, Hampton Road DS0000017368.V309949.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 45a, Hampton Road DS0000017368.V309949.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): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Information about the home is available to residents. Residents’ individual needs are effectively assessed. Any changes in need receive an appropriate response. EVIDENCE: The home has produced a Statement of Purpose, which gives details of the services and facilities provided and the aims and objectives of the service. A Service User Guide is issued to all residents. Residents’ needs are effectively identified through the assessment process and are kept under review. The inspection provided evidence that any changes in residents’ needs receive an appropriate response. There is a commitment to person-centred planning and to delivering a service that reflects residents’ needs and aspirations. Staff know residents’ needs well and liaise effectively with other stakeholders, such as residents’ family members, and professionals when necessary. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 9 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 the home. The home records residents’ needs and strengths and works with residents to identify goals that are important to them. Residents receive good support to make informed choices about their lives. Residents are able to choose how they spend their time. Staff understand residents’ individual needs. There is a commitment to supporting residents in taking manageable risks. EVIDENCE: Each resident has an individual care plan, which address areas including self care, healthcare, communication, relationships, community presence and participation and records preferences in terms of daily routines and leisure activities. The care plans examined were highly individualised and regularly 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 11 reviewed. Residents’ goals and aspirations are recorded and the support needed to achieve these objectives is identified. Keyworkers are currently supporting residents to develop yearbooks, which the manager advised are to be used in conjunction with care plans. The yearbook examined during the inspection made good use of photographs and annotations to record residents’ activities and to demonstrate residents’ preferences in their daily lives. The manager and staff demonstrated a good knowledge of residents’ individual needs and a commitment to supporting residents in making informed decisions about their lives. Staff interacted positively with residents during the inspection visit and encouraged residents to make choices where possible. Discussion with staff demonstrated that the home has a commitment to supporting residents in taking manageable risks. The sample of risk assessments examined provided clear information and evidence of review. Staff sign to record their understanding of individual risk assessments. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 – 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the home. Residents are encouraged to involve themselves in the routines of the home. Residents are involved in their local community. Residents take part in a wide variety of leisure opportunities. Residents are supported to develop and maintain relationships with their families and friends. The home’s menu is varied, healthy and is enjoyed by residents. EVIDENCE: The manager reported that residents are increasingly encouraged to involve themselves in the routines of the home, with staff support, such as making 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 13 breakfast or cleaning their room. One resident was involved in preparation of the meal served during the inspection. There is evidence that residents know their local community well and are involved in a range of day opportunities. Care plans demonstrated that residents make regular use of local shops, parks, pools and other community resources. Recent leisure activities had included meals out, boat trips and a holiday in Norfolk. All residents attend the Avenue Centre as part of their day opportunities programmes. The Centre has allocated a linkworker to the home and staff from the Centre supported an Intensive Interaction session for residents during the inspection. Staff are aware of the planned closure of the resource centre and are working with the linkworker to arrange day opportunities for residents outside the resource centre environment. Residents receive good support to maintain relationships with their families and almost all residents have some family contact. The home is actively supporting residents in developing friendships and the manager provided several examples of positive outcomes for residents in this area. Interaction between staff and residents was positive during the inspection. Residents’ wishes and needs are clearly identified in their individual plans. Staff used appropriate forms of address when speaking to residents. Residents made clear choices about how they spent their time at the home during the inspection. Any restrictions on residents’ movement (such as unaccompanied access to the kitchen) and the rationale for these restrictions are recorded. The home is commended for the extensive work involved in developing the new menu, which meets a wide range of dietary needs yet remains varied, appetising and enjoyed by residents. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 the home. Residents receive personal support in the way they prefer. Residents’ healthcare needs are met. Residents are supported to access community and specialist healthcare resources where necessary. Residents’ medication is appropriately stored and accurately recorded. EVIDENCE: The deputy manager stated that all residents have an annual heath check and have regular appointments with the dietician, dentist and chiropodist. Other relevant professionals, such as speech and language therapist and physiotherapist, are consulted as and when necessary. Individual care plans confirmed that medical appointments are made if needed and that appropriate healthcare professionals are involved in residents’ care. Care plans also identified residents’ individual support needs and contained 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 15 guidelines for the delivery of care to ensure that staff work consistently with residents. A Health Action Plan has been developed for each resident. Inspection of a sample of Health Action Plans demonstrated that these documents provide clear information about residents’ healthcare needs and that these details are regularly reviewed. There is an appropriate system for the storage and administration of medication. Double signatures are used to record the administration of medication. Sample staff signatures are held on file. Residents’ photographs are included on their medication records. All medication coming into or leaving the home is recorded. Inspection of medication records for three residents revealed no omissions or errors. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 the home. Appropriate procedures are in place for the management of complaints. Appropriate guidance is provided for staff in the recognition, prevention and reporting of abuse. United Response acted appropriately following allegations about the conduct of a member of staff. EVIDENCE: The home has an appropriate Complaints procedure. There have been no complaints made about the home since the last inspection. The service works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’. United Response has a Whistle-blowing procedure, which enables staff to report any concerns about they have about poor practice. Since the last inspection, an ex-employee made allegations about the conduct of a member of staff employed at the home. United Response acted appropriately following the allegations, suspending the member of staff concerned and attending multi-agency Protection of Vulnerable Adults (POVA) meetings to identify the best means of investigating the allegations. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 17 The POVA group asked the organisation to conduct an internal investigation. Following this investigation, performed by an appropriate senior member of staff, the member of staff named in the allegations was exonerated. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 18 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, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The communal rooms of the home are welcoming and homely. Residents’ bedrooms reflect individual preferences. Specialist equipment and adaptations have been installed where necessary. The home is clean and hygienic. EVIDENCE: The home is situated in a pleasant residential area and has good access to local community facilities, open spaces and public transport networks. The communal rooms of the home include a lounge/dining area, which opens onto a well maintained garden, and a kitchen. Any restrictions on residents’ access to communal areas are recorded. All residents’ bedrooms are situated on the ground floor of the home and some residents have access to en suite bathroom facilities. Specialist equipment and 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 19 adaptations have been installed where necessary to facilitate residents’ mobility and bedrooms reflect individual tastes and preferences. All areas of the home were clean and hygienic. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 20 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, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home has a stable staff team that provides good quality care to residents. Staff are appointed following an appropriate recruitment and selection procedure. Staff receive effective induction, supervision and support. Staff attend training appropriate to their roles. EVIDENCE: The home benefits from a stable staff and management team. Staff interacted positively with residents during the inspection and demonstrated a good knowledge of their needs. Discussion with staff confirmed that there is commitments to running the home in the best interests of residents and to ensuring residents’ wishes are met wherever possible. Two staff files were examined. Both provided evidence of a robust recruitment procedure and confirmed that the home carries out appropriate preemployment checks on staff, including Criminal Records Bureau disclosures. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 21 Staff files also contained a job description, code of conduct and evidence that staff complete a six-month probationary period before being confirmed in post. Staff are encouraged to attend training relevant to their roles and all staff receive regular one-to-one supervision. Staff said that United Response arranges updates in mandatory training every three years. All staff had attended two days of a three day course in Intensive Interaction at the time of inspection and the manager reported that staff will attend Makaton training in the near future. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 22 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, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home has a skilled and experienced manager. The manager provides good support and leadership to the staff team. Systems of recording and administration within the home are well organised and maintained. Staff work within defined guidelines and a clear procedural framework. Staff are committed to running the home in residents’ best interests. The health and safety of residents and staff is maintained. EVIDENCE: 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 23 The manager has a good deal of experience in her role and has a commitment to the continuous improvement of the service. Staff reported that the manager is approachable, supportive and provides appropriate leadership to the team. Staff also said that their views are listened to and that they are encouraged to contribute to the running of the home. Systems of recording and administration within the home are well organised and maintained. Written information is clear and usable by staff. Staff are issued with a ‘Code of Conduct’ and work within the policies and procedures developed by the organisation. There is a Service Plan in place that addresses the period April 2006 until March 2007. The Plan identifies both team objectives, such as the successful implementation of person-centred planning, and individual goals for each resident. United Response is committed to obtaining the views of people who use and work within the organisation’s services. Residents are consulted about decisions taken within the home. Each resident has a keyworker, who aims to provide advice and support where required. Financial records for two residents were examined, including cash books and balances, and found to be accurate. Staff conduct regular health and safety checks, which include temperature monitoring, food storage, first aid equipment, COSHH storage and fire equipment. Daytime fire drills take place monthly. The most recent on file was held on 27 June 2006. Night time fire drills take place twice each year. The most recent on file was held on 17 April 2006. The home’s emergency lighting and fire alarm system was checked in May 2006. 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 24 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 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 3 25 3 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 3 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 45a, Hampton Road DS0000017368.V309949.R01.S.doc Version 5.2 Page 26 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. 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