Inspection on 06/07/06 for 5-7, Cedars Road

This inspection was carried out on 6th July 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

5-7, Cedars Road 06/09/07

5-7, Cedars Road 22/12/05

5-7, Cedars Road 12/07/05

5-7, Cedars Road 16/12/04

5-7, Cedars Road 24/06/04

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 5-7, Cedars Road Hampton Wick Kingston-upon-thames Surrey KT1 4BG Lead Inspector Simon Smith Unannounced Inspection 6th July 2006 1:15pm 5-7, Cedars Road DS0000017355.V305915.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 5-7, Cedars Road DS0000017355.V305915.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. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 5-7, Cedars Road Address Hampton Wick Kingston-upon-thames Surrey KT1 4BG 020 8943 2668 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) cedars@rhlt.org.uk Richmond Homes for Life Trust Ms Jackie Harris Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can admit one named service user who is over 65 years of age. 22nd December 2005 Date of last inspection 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. The Homes For Life Trust is a registered charity operating a number of services locally, including supported living projects and a leisure break scheme. The home’s fees currently range from £31272 to £32940 per annum. The home is situated in a pleasant residential area, close to the River Thames and within walking distance of community facilities, shops and public transport networks. A high standard of decoration has been achieved throughout the home and the property has a large, well-maintained garden. 5-7, Cedars Road DS0000017355.V305915.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 (13:15 18.00) and discussion with residents, the 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 30 of 33 National Minimum Standards assessed at this visit. Three Standards were almost met. Two Requirements made at the last inspection had not been met by the home and are reinstated in this report. Surveys were given to residents, relatives, staff and professionals who visit the home. Three residents returned surveys, two of whom received support to complete them. Six relatives and three staff also returned questionnaires. Residents said that staff provide good support when they need it and that they would feel confident in approaching staff if they had a problem or complaint. Residents also said that they are able to choose how they spend their time and that they are involved in the running of the home. Comments made by residents included: “I like my home” “It’s a nice house with friendly people” 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. When asked what the home does well, several relatives commented on the homely atmosphere and skills of the manager and staff team. Relatives also said that the home ensures residents’ healthcare needs are met and provides residents with opportunities to develop their skills and achieve independence. When asked what the home could do better, two relatives commented that they would like to see staff support available to enable residents to attend social activities at weekends and in the evenings. One relative said that they would like to be informed of staff changes when they happen. Comments made by relatives included: “They really care about each resident as an individual whilst encouraging their interaction as a group” “Staff are very caring, understanding and patient” “They have (resident’s) best interests at heart”. “Friendly staff and atmosphere, homely surroundings” “Homely and caring environment“ 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 6 “There is a welcoming, happy and homely atmosphere” “Good rapport between staff and residents” “Excellent care and support” “First class communication” “An excellent manager who initiates an aura of warmth and care” Staff said that they receive good support to do their jobs, including regular supervision and training opportunities. When asked to identify what the home does well, staff said that the service meets residents’ individual needs and communicates well with residents and their families. What the service does well: What has improved since the last inspection? What they could do better: Produce a Service User Guide and supply a copy to each resident. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 7 Ensure that each resident has a licence agreement that accurately reflects the terms and conditions of their placement and contains all information specified in Standard 5 of the National Minimum Standards. Review residents’ care plans at least every six months. 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. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 8 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 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 9 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, 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Information about the home must be made available to residents. Residents’ individual needs are appropriately assessed. Residents must be issued with a written agreement that accurately reflects the terms and conditions of their placement. EVIDENCE: The Trust has yet to produce a Service User Guide, although has commissioned a filmmaker to produce the guide in DVD format. The manager advised that the project was almost complete and several residents said they had been involved in the production of the DVD. In addition to the DVD, the Trust must ensure that all information required by the Care Homes Regulations (2001) is included in a written Service User Guide. See Requirement 1. Needs assessments were in place on the sample of care plans examined. Assessments addressed needs, strengths, including self care and independent living skills, leisure and social interests. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 10 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 11 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, 8, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Staff understand residents’ individual needs. There is a commitment to person-centred planning. Residents receive good support to make 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, although two of the three examined required review. See Requirement 3. Care plans examined contained good, individualised information about each resident, identifying strengths, needs and support networks. There was little evidence of residents’ 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 12 involvement in the development of their care plans and the home should aim to improve in this area. Discussion with staff and residents demonstrated that the home has a commitment to promoting residents’ rights to make choices about their lives. There is also a commitment to implementing person-centred planning and an awareness of the need to balance residents’ rights and wishes with effective risk management. A new risk assessment format has recently been introduced in the home. Residents’ confirmed that they are able to choose the way in which they spend their time at the home and that their individual programmes reflect their interests and preferences. Residents are consulted about how the home runs and are involved in the routines of the home such as cleaning, shopping and cooking. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to the home. Residents lead varied and fulfilling lives. Residents enjoy the activities in which they take part. Residents are involved in their local community. Residents are supported to develop and maintain relationships with their families and friends. Residents are involved in planning the home’s menu and preparing meals. EVIDENCE: Residents lead busy and fulfilling lives and receive good support to access a range of opportunities in employment, education and leisure. Residents’ surveys indicated that they are able to choose what they want to do with their 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 14 time and residents spoken to during the inspection said that they enjoyed the range of activities they take part in. One resident played golf on the day of inspection and another went bowling. Another resident reported that he had attended a music workshop. Two residents said that they enjoy the classes they take at college and said that they are able to choose which courses they attend. Six residents attend the Avenue Centre regularly and staff reported that they liaise closely with the home’s allocated linkworker from the Centre. Staff said that residents are increasingly participating in activities outside away the Centre in preparation for its closure for redevelopment from February 2007. Residents were involved in the routines of the home on the day of inspection, including cooking, vacuuming and laundry. Three residents travel independently. Residents have regular contact with friends and relatives and some take holidays with their families. One resident attends church regularly with staff support. Interaction between staff on duty and residents was positive during the inspection. Residents have unrestricted access to all communal areas of the home. Residents’ wishes and needs are clearly identified in their individual plans. Staff used appropriate forms of address when speaking to residents. Residents meet regularly to choose the home’s menu and said that they enjoy the food provided at the home. Responsibility for cooking and preparing food is shared amongst residents and the staff team. All staff undertake basic food hygiene training as part of their induction process. Standards of food hygiene and storage at the time of inspection were good. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 15 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 are supported to access community and specialist healthcare resources where necessary. Changes in need are effectively identified and receive an appropriate response. Residents’ medication is appropriately stored and accurately recorded. EVIDENCE: The inspection provided evidence that healthcare conditions are managed effectively and that the home seeks specialist advice where necessary. Care plans identified residents’ individual support needs and contained guidance for staff delivering care. Staff on duty demonstrated a good knowledge of residents’ healthcare needs. There is an appropriate system for the storage of medication and clear protocols governing administration. Staff sign to record their understanding of the home’s medication policy. The manager checks medication records weekly. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 16 Inspection of medication records for three residents revealed no omissions or errors. The manager advised that the pharmacist conducts two visits each year to check the home’s arrangements for medication, one of which was due to take place in the week after inspection. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 17 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. Residents feel confident about raising concerns with staff. Training and guidance is provided for staff in the recognition, prevention and reporting of abuse. EVIDENCE: The home has an appropriate Complaints procedure. There have been no complaints made about the home since the last inspection. All residents completing surveys said that they would know who to speak to if they were not happy about something at the home. Residents spoken to during the inspection said they would feel confident in approaching staff with a complaint if necessary. The manager advised that all but the home’s new staff have attended training in the Protection of Vulnerable Adults in the last year. 5-7, Cedars Road DS0000017355.V305915.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, 26, 27, 28, 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. The home is clean and hygienic. EVIDENCE: The home is situated in a pleasant residential area, close to the River Thames and within walking distance of local community resources and public transport networks. A high standard of decoration has been achieved throughout the home and the property has a large, well-maintained garden. Communal rooms include a lounge, an open plan kitchen/dining area, and a games room, which provides activities such as snooker and table football. Toilet and bathroom facilities are available on both floors of the home. Residents’ bedrooms are personalised 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 19 and provide evidence of interests, hobbies and individual achievements. All areas of the home were clean and hygienic. 5-7, Cedars Road DS0000017355.V305915.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): 31, 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. Residents feel that staff listen to them and act on what they say. Staff are appointed following an appropriate recruitment and selection procedure. Staff attend training appropriate to their roles. Staff receive good support from the manager. 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. Residents spoken to during the inspection said that staff listen to them and act upon what they say. There was a clear shift plan in place and staff had a good awareness of their roles and responsibilities. Handovers are given by staff completing their shift to those beginning work. Records demonstrated that staff meetings take place 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 21 regularly and are used effectively to address important issues within the service. Records for two members of staff were examined. Both provided evidence of a robust recruitment procedure and confirmed that the home carries out appropriate pre-employment checks on staff, including Criminal Records Bureau disclosures. Staff are encouraged to attend training relevant to their roles. Two staff reported that they had almost completed National Vocational Qualifications (NVQ) and that the home facilitates regular contact with an assessor. The manager said that the home’s new staff will be registered for NVQ awards in September 2006. All staff receive regular supervision and the manager advised that a system of annual appraisal will be introduced in the near future. 5-7, Cedars Road DS0000017355.V305915.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 leadership and guidance. Staff are committed to running the home in residents’ best interests. The health and safety of residents and staff is maintained. EVIDENCE: The manager has significant experience in her role and has achieved relevant qualifications, including the Registered Managers Award, and has almost completed NVQ level 4. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 23 The manager provides good support to the staff team and encourages their input in the running of the home. The manager presents a positive role model for staff in her interactions with residents and has a commitment to the continuous improvement of the service. Discussion with the manager and 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. The home aims to seek residents’ views through regular meetings, which are supported by staff. Residents are encouraged to involve themselves in the routines of the home and are consulted about decisions in the home that affect them. Health and safety records provided evidence of weekly fire point tests and monthly emergency lighting tests. The last fire drill took place on 18 May 2006. The fire alarm system was serviced in February 2006 and fire fighting equipment checked in May 2006. Accident/incident records were accurate and up-to-date. The home has valid Employers Liability Insurance until September 2006. 5-7, Cedars Road DS0000017355.V305915.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 2 2 3 3 X 4 X 5 2 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 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 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 2 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 YA1 Regulation 5 Requirement The Registered Person must produce a Service User Guide and supply a copy to each resident and to the CSCI. This Requirement is reinstated from the last inspection. The Registered Person must ensure that the licence agreements issued to residents contain all information specified in Standard 5 of the National Minimum Standards. Timescale for action 30/08/06 2 YA5 5(1)(c) 30/08/06 3 YA6 This Requirement is reinstated from the last inspection. 15(2)(b)(c) The Registered Person must ensure that care plans are reviewed at least every six months. 30/08/06 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 Good Practice Recommendations DS0000017355.V305915.R01.S.doc Version 5.2 Page 26 5-7, Cedars Road 1 Standard YA6 The Registered Person must seek to involve residents more in the development of their care plans. 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 5-7, Cedars Road DS0000017355.V305915.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!