Inspection on 12/07/05 for 5-7, Cedars Road

This inspection was carried out on 12th July 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

5-7, Cedars Road 06/09/07

5-7, Cedars Road 06/07/06

5-7, Cedars Road 22/12/05

5-7, Cedars Road 16/12/04

5-7, Cedars Road 24/06/04

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Cedars Road, 57 5-7 Cedars Road Hampton Wick Kingston Upon Thames KT1 4BG Lead Inspector Simon Smith Unannounced 12 July 2005 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 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 Stationary 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. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 5-7 Cedars Road Address 5-7 Cedars Road Hampton Wick Kingston Upon Thames Surrey KT1 4BG 020 8943 2668 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Richmond Homes for Life Trust Ms Jackie Harris CRH 8 Category(ies) of 8 LD (Learning disability) registration, with number 8 PD (Physical disability) of places G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16.12.04 Brief Description of the Service: The property is owned and maintained by the Richmond Churches Housing Trust. The service is operated and managed by Richmond Homes For Life Trust, a registered charity operating a number of services locally. The home is situated in a quiet residential street, although benefits from proximity to public transport networks and good shopping and community facilities. A high standard of decoration has been achieved throughout the home and the property has a large, well-maintained garden. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the course of a single afternoon and involved discussion with six residents, the manager and members of the staff team. A sample of records was examined and a tour of the premises made. The inspector was made welcome throughout the visit and wishes to acknowledge the time and consideration that residents, the manager and staff provided during the course of the inspection. The home met 18 of 25 National Minimum Standards assessed at this visit. One Standard was almost met. Richmond Homes for Life Trust had failed to take action to ensure that all Requirements made following the last visit were met. An individual plan is in place for each resident, which reflects individual skills, strengths, needs and goals. The home is committed to person-centred planning and has a clear commitment to enabling residents to make choices about their lives. Residents are consulted about decisions that affect them and are encouraged to take part in the daily life of the home. Residents are actively involved in their local community and take part in a range of leisure activities. The manager and staff have a good knowledge of residents’ needs. All residents are registered with local doctors and staff help residents to get specialist advice or treatment when they need it. Residents are able to have privacy when they want it and staff talked to residents with respect during the inspection. The home has a Complaints procedure, which explains how people can complain and how the complaint will be investigated. Residents felt confident that any complaints they made would be listened to. The communal rooms of the home were welcoming and homely and bedrooms reflected residents’ tastes and preferences. The home has an open plan kitchen/dining room, which was a focus for socialising during the inspection. There are enough toilets and bathrooms to meet residents’ needs. All parts of the home were clean and hygienic. The manager is experienced and knows the home well. The manager is committed to improving the home where possible and presented a good role model for staff. The inspector was able to speak to one member of agency staff who was working her first shift at the home. The member of staff confirmed that she had been given good information about her role before starting work. The manager reported that three staff are working towards a National Vocational Qualification (NVQ) level 3 although four others have yet to start NVQ training. It is recommended that all staff without National Vocational Qualifications are registered on courses designed to achieve them. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 6 What the service does well: 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. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 standard(s) 1, 3 Residents’ needs and strengths are effectively identified. Residents receive good support to achieve their goals and aspirations. Written information for residents about the home must be improved. EVIDENCE: The home is committed to ensuring that individual plans are person-centred and reflect the needs and aspirations of residents. (See also Standard 6). Comments made by residents indicate that the home meets their needs well and that they receive good support from staff. Staff liaise effectively with other agencies and residents receive support to access specialist services where necessary. The design and layout of the home meets the needs of those who live there and its location enables good access to community resources and leisure facilities. The Homes for Life Trust has yet to produce a Service User Guide. This issue has been identified in the last two inspection reports and the Requirement made is reinstated here. See Requirement 1. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8, 9 The home records residents’ needs and strengths well and works with residents to identify goals that are important to them. The manager and staff understand residents’ individual needs. Residents receive good support to make informed choices about their lives. Residents are consulted about issues that affect them in the home. Residents are involved in the running of the home. EVIDENCE: An individual plan of care is in place for each resident. A standard format is used for this purpose and the standard of recording was found to be good. Care plans reflect the individual skills, strengths, needs and goals of residents and record preferences in terms of daily routines and leisure activities. The home is committed to person-centred planning. Staff advised that a personcentred planning co-ordinator had attended the most recent staff meeting and one member of staff has completed a person-centred planning facilitator course. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 10 The last inspection report identified that residents’ reviews had not been taking place as often as necessary. The manager advised that, as residents’ placing authorities had not allocated a care manager, reviews had now been planned by the home for all residents and the relevant placing authorities informed. The manager reported that other relevant parties, including family members where appropriate, would also be invited to attend reviews. Discussion with staff and residents demonstrated that the home has a clear commitment to promoting the rights of residents to make choices about their lives. Risk assessments have been developed for specific activities undertaken by residents and have been completed with input from residents. Residents are also encouraged to involve themselves in the routines of the home (see Standard 11) and are consulted on decisions in the home that affect them. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15 Residents are encouraged to involve themselves in the routines of the home and to develop independent living skills. Residents participate in a range of activities appropriate to their needs and preferences. Residents are involved in their local community. Residents are supported to develop and maintain relationships with their families and friends. EVIDENCE: Residents are encouraged to develop the skills required for independent living through involvement in the routines of the home. One resident was observed to prepare his lunch without support. One resident reported that the main house shopping is delivered but that he often goes out to buy small items for the home. Residents reported that they do their ‘house jobs’ on their home base day and that these include laundry and room cleaning. One resident G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 12 reported that he cuts the lawn. One resident advised that he would be cooking the evening meal for other residents and reported that residents cook on a rota basis, with support from staff where necessary. Some residents are able to travel independently. Staff advised that another resident currently attends travel training sessions at a resource centre. One resident reported that he had been shopping and for a haircut on the day of inspection and had travelled independently by public transport. One resident reported that that he works two days each week and that he enjoys his job. The resident also advised that he had finished college for the year and he planned to return in September. Six residents currently attend a number of sessions each week at the Avenue Centre in Teddington. Staff and residents are aware of the planned closure of the Centre from Autumn 2005 and have attended consultation meetings to discuss the future of day services. Residents are actively involved in the local community and take part in a wide range of social and leisure activities. One resident reported that he enjoys going to the pub on his own and joining the group for outings on Fridays. Residents reported that they enjoy activities including bowling, pubs, restaurants and the cinema. Most residents have regular contact with their families. One resident advised that he visits his parents for lunch each weekend. Residents are supported by staff to visit family members if their relatives are unable to visit the home. One resident was visited by a friend during the inspection. All residents have at least one annual holiday. Staff reported that three residents had visited CentreParcs earlier in the year whilst another group had hired accommodation in the West Country. Two residents were planning to take a holiday together later in the year. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 standard(s) Care staff have a good awareness of residents’ emotional and healthcare needs. Residents access community and specialist healthcare resources where necessary. EVIDENCE: All residents are registered with local general practitioners and access other community healthcare resources as necessary. Two residents had attended routine health checks on the day of inspection. Staff on duty demonstrated a good awareness of residents’ healthcare needs. Care plans identified residents’ individual support needs and contained guidance for staff delivering care. Interaction between staff and residents was positive throughout the inspection. Staff knocked before entering private accommodation and addressed residents with respect. Residents were afforded sufficient time to complete tasks at their own pace. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 standard(s) 22 Appropriate procedures are in place for the management of complaints. Residents feel any concerns raised would receive appropriate action. EVIDENCE: The Homes For Life Trust has an appropriate Complaints procedure, a copy of which is on file at the home. The policy clarifies timescales for action and response and provides alternative contacts should the complainant be dissatisfied with the outcome of the complaint. Advice on how to register a complaint is displayed on the residents’ noticeboard. A record of complaints is maintained. The most recent entry in this log is dated July 2003. The record provides evidence that the home responded appropriately to this complaint. Residents spoken to during the inspection were confident that any concerns raised by them would receive an appropriate response. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 27, 28, 30 The home is comfortable, safe and well maintained. The home is clean and hygienic. Communal and private rooms are homely, well decorated and reflect residents’ preferences. EVIDENCE: The home is situated in a pleasant residential area and has good access to local community facilities, public transport networks and open spaces. The property is owned and maintained by Richmond Churches Housing Trust whilst the service is managed by Richmond Homes For Life Trust. The Homes For Life Trust pays rent and an annual fee to the Housing Trust. A high standard of decoration has been achieved throughout the home and the property has a large, well-maintained garden. The adjacent garage has been converted to a games room, which provides activities such as snooker and table football. Communal rooms were clean, welcoming and homely and private accommodation indicated individual tastes and preferences. The home G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 16 has an open plan kitchen/dining area, which formed a focus for socialising during the inspection. Toilet and bathroom facilities are accessible and are available in sufficient numbers. The last inspection report required the home to repair the tiling in one bathroom. The manager advised that all bathrooms in the home will be retiled in the near future. All areas of the home were clean and hygienic at the time of inspection. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 Staff have an awareness of their own and one another’s’ roles. Staff communicate effectively with one another and have a good awareness of residents’ needs. Staff should be provided with the opportunity to achieve a relevant National Vocational qualification. EVIDENCE: The Home has a clear staffing and management structure. Job descriptions and contracts of employment are in place for all posts within the staff team. Staff communicated well with one another and engaged meaningfully with residents, seeking preferences and offering choices where possible. A clear shift plan was observed to be in place, listing residents’ appointments and activities. Handovers are given by staff finishing their shift to those beginning work. A communication book and house diary are maintained. The inspector was able to speak to one member of agency staff who was working her first shift at the home. The member of staff confirmed that she had been given good information about her role before starting work, including an introduction to residents, familiarisation with care plans and the working practices of the home. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 18 The manager advised that three staff are working towards a National Vocational Qualification (NVQ) level 3 although four others have yet to commence NVQ training. It is recommended that all staff without National Vocational Qualifications are registered on courses designed to achieve them. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 42 Systems of recording and administration within the home are clear and well organised. The home has a motivated and experienced manager. The health and safety of service users and staff within the Home is maintained. EVIDENCE: Systems of recording and administration within the home are clear and well organised. The manager has a number of years experience in her role and clearly knows the home and residents well. The manager is committed to the development of the service and presented a good role model for staff in her interactions with residents. The home was clean, hygienic and free of obvious health and safety hazards on the day of inspection. All COSHH products were stored appropriately. The G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 Page 20 home has an appropriate fire detection system. Clear instructions for use in the event of a fire were displayed. G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score 3 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x G54-G04 S17355 Cedars Rd V239336 120705 Stage 4.doc Version 1.30 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. Standard 1 Regulation 5 Requirement The Registered Person must produce a Service User Guide and supply a copy to each resident and to the CSCI. (Reinstated from last inspection on 16.12.04) Timescale for action 30.09.05 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. Refer to Standard 32 Good Practice Recommendations Provide all staff with the opportunity to achieve a relevant National Vocational Qualification. 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