Inspection on 06/09/07 for 5-7, Cedars Road

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

Other inspections for this house

5-7, Cedars Road 06/07/06

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 September 2007 5-7, Cedars Road DS0000017355.V351412.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.V351412.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.V351412.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 Jackie Harris Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2006 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.V351412.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 range of sources when making judgements about the home. These included visiting the home and talking to residents, staff and the manager. Some written information was checked, including staff and residents’ files. The inspector was made welcome during the visit and wishes to thank all those who gave their views about the home. Four residents returned surveys to the CSCI. Residents said that they like living at the home and feel safe and well cared for. Residents said that staff provide good support when they need it and that they would feel confident speaking to staff if they had a problem or complaint. The home met 26 of 33 National Minimum Standards assessed at this visit. Four Standards were exceeded and three Standards were almost met. Three residents were on holiday at the time of inspection. One resident went to a local resource centre during the visit and one resident was supported by staff to attend a medical appointment. What the service does well: Provides a stable staff and management team that provides consistent care and support to residents. Provides an individualised service based on residents’ needs. Provides good opportunities for personal development. Supports residents to develop their skills and abilities. Promotes residents’ participation in their community. Provides a supportive and homely environment. Provides opportunities for residents to access a range of social and leisure activities. Supports residents to develop and maintain positive relationships with their friends and families. Identifies any changes in residents’ needs and ensures access to appropriate care and support. Works well with other appropriate professionals where necessary. 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 5-7, Cedars Road DS0000017355.V351412.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 5-7, Cedars Road DS0000017355.V351412.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): Standards 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is clear information about the home and the service it provides. Residents’ individual needs are appropriately assessed. EVIDENCE: Richmond Homes for Life Trust has commissioned a DVD to provide information about services in a format that is accessible to all residents. Care plans indicated that residents’ needs are effectively identified through the assessment process and that this information forms the basis of care and support delivered. The home is committed to ensuring that individual plans are person-centred and reflect the needs and aspirations of residents. 5-7, Cedars Road DS0000017355.V351412.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): Standards 6, 7, 8 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are involved in the development of their care plans. Care plans are person-centred and regularly reviewed. Residents receive good support to make choices about their lives. EVIDENCE: Residents’ care plans contain individualised information about their strengths and needs and make good use of photographs to illustrate how residents spend their time. Care plans also identify important people in residents’ lives and contain good information about individual preferences in terms of daily living. There was evidence that care plans are regularly reviewed and updated. Separate care plans had been developed for any ongoing medical conditions. 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 10 Staff demonstrated a good knowledge of residents’ needs and a commitment to supporting residents in making decisions about their lives. The service consults significant others, such as family members and care managers, where appropriate about residents’ care. Residents’ said that they are able to choose how they spend their time at the home and that they are consulted about how the home runs. Residents also said that they are able to make decisions about their lives and that staff provide support in this area if they need it. The home carries out appropriate risk assessments to enable residents to take risks as part of an independent lifestyle, such as staying at the home unaccompanied or using potentially dangerous products without support. There was evidence that residents had been involved in the development of the risk assessments checked at inspection and that risk assessments are regularly reviewed, although one resident’s medication risk assessment needed review (see Standard 20). 5-7, Cedars Road DS0000017355.V351412.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): Standards 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ have individual programmes that reflect their needs and interests. Residents are involved in the daily routines of the home. Residents have active social lives and are involved in their local community. Residents receive good support to maintain relationships with their friends and families. Residents are able to contribute to the home’s menu and are involved in cooking meals. EVIDENCE: 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 12 Residents do much for themselves and are involved in the routines of the home such as cleaning, shopping and laundry. As well as keeping their own rooms clean, residents are expected to take part in the cleaning rota. Residents said that staff help them with tasks if necessary. Residents lead busy and fulfilling lives and receive good support to access a range of opportunities. Some residents have regular employment and some go to college. Most residents used to attend the Avenue Centre regularly but day opportunities are now community based. The manager said that this means that staff spend more of their time dropping and collecting off residents than previously. Residents are involved in their local community and receive good support to maintain relationships with their friends and families. There was evidence that residents had recently taken part in activities including going out for meals or to the pub, celebrating birthdays, going to church and going swimming. Residents said that they have access to activities they enjoy and talked about their hobbies, jobs, college and holidays. Three residents were on holiday in the Isle of Wight at the time of inspection. Richmond Homes for Life Trust is considering using the home’s games room for temporary office accommodation due to the loss of its current office facilities. The Trust has an obligation under the Care Homes Regulations (2001) to consult with residents about any proposed changes to their home. The Trust must provide evidence that consultation with residents has taken place about this issue. See Requirement 1. Residents are able to contribute to the home’s menu and are involved in cooking meals. The home has a large kitchen/diner, which is the focus of socialising around meal times. Of the four residents who returned surveys, three said that they “always” liked the food at the home all the time, and one said that they “sometimes” liked the food. 5-7, Cedars Road DS0000017355.V351412.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): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to access specialist healthcare resources where necessary. The home works co-operatively with other professionals in delivering residents’ care. Residents’ medication is appropriately stored and recorded. Residents are supported to control their own medication, although risk assessments relating to self medication should be reviewed more often. EVIDENCE: Residents’ healthcare conditions are monitored well and all accidents and incidents are recorded. Care plans provided evidence that medical appointments are made if needed and that appropriate healthcare professionals are involved in residents’ care where necessary. The manager 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 14 described how the home is supporting one resident to address a healthcare issue. There is an appropriate system for storing medication and there are clear, written procedures governing the administration of medication. The home has an arrangement with the supplying pharmacist for advice and annual inspections. One resident self medicates. There was evidence that staff support the resident with this where necessary and of an appropriate risk assessment, although this has not been reviewed January 2006. This should be reviewed more frequently. See Requirement 1. 5-7, Cedars Road DS0000017355.V351412.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): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are appropriate procedures for the management of complaints. Residents feel confident about raising concerns with staff. Training is provided for staff in the Protection of Vulnerable Adults, though some staff need to attend refresher training. EVIDENCE: The home has a Complaints procedure and records all complaints. There have been no complaints since 2003. Residents said they would feel confident speaking to staff if they had a problem or complaint. The home works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’, which provides guidance for staff in the recognition and reporting of abuse. Staff have attended Protection of Vulnerable Adults training but some staff need to attend refresher training in this area (see Standard 35). As outlined in the Lifestyle section of this report, Richmond Homes for Life Trust is considering using the games room for temporary office space. The CSCI has concerns that this could enable people without appropriate checks to gain access to the home. Should this move go ahead, Richmond Homes for Life Trust must obtain a Criminal Records Bureau disclosure for all those with 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 16 access to the home and provide details of how they will supervise any visitors to the office. 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 17 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): Standards 24, 25, 27, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe and well decorated. 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 and has good access to local community facilities, open spaces and public transport networks. A good standard of decoration has been achieved throughout the home and the property has a well-maintained garden. 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 18 The communal rooms include a lounge, an open plan kitchen/dining area, and a games room. Toilet and bathroom facilities are available on both floors of the home. Residents’ bedrooms are personalised and provide evidence of interests, hobbies and individual achievements. Residents said they like their bedrooms and are able to keep them as they wish. All areas of the home were clean and hygienic. The proposal that Richmond Homes for Life Trust use the games room for temporary office space would necessitate office staff using the home’s bathrooms. Should this move go ahead, the home’s bathroom arrangements will not meet the National Minimum Standards for care homes for adults, which state that bathrooms should offer residents “sufficient personal privacy”. 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 19 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): Standards 31, 32, 33, 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. The home benefits from a stable staff and management team. 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 but some staff need refresher training in core areas. EVIDENCE: The manager and most staff have worked at the home for some time and know residents well. The manager said that the home has access to bank staff if necessary and uses agency staff “very rarely”. Staff interacted positively with residents during the inspection and demonstrated a good knowledge of their needs. 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 20 Staff work to a clear shift plan, which ensures that staff know their responsibilities that day. All staff have achieved a minimum of NVQ level 2 and some are working towards NVQ level 3. Staff records provided evidence of a robust recruitment procedure and that the Trust carries out appropriate pre-employment checks on staff, including Criminal Records Bureau disclosures. Files demonstrated that staff attend regular individual supervision and have an annual appraisal. Staff also meet together regularly as a group. The staff training record indicated that some elements of core training need updating, including Protection of Vulnerable Adults (some staff had not attended this since December 2004), fire (some staff had not attended this since May 2004) and First Aid (some staff had not attended this since November 2003). See Requirement 3. 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 21 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): Standards 37, 38, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a skilled and experienced manager. The manager provides good leadership and guidance. There is a commitment to seeking residents’ views and to running the home in residents’ best interests. The health and safety of residents and staff is maintained. EVIDENCE: 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 22 The manager has significant experience in her role and has achieved relevant qualifications, including NVQ level 4 and the Registered Managers Award. 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. The manager and staff are committed to running the home in residents’ best interests and to ensuring residents’ wishes are met wherever possible. Residents meetings are held regularly, supported by staff. Staff carry out a monthly health and safety check. Records of these checks were up to date at the time of inspection. There are clear instructions for use in the event of a fire, which were updated in July 2007. Staff test the alarm each week using different call points. The last fire drill took place in August 2007. The home’s fire fighting equipment was serviced in January 2007 and the emergency lighting serviced in July 2007. 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 23 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 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 4 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 4 3 X X 3 X 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 24 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. 1 Standard YA16 Regulation 12 Timescale for action The Registered Person must 30/11/07 provide evidence that residents have been properly consulted about using the games room for temporary office accommodation. The Registered Person must ensure that risk assessments relating to self medication are regularly reviewed. The Registered Person must ensure that staff attend regular refresher training in core areas. 30/10/07 Requirement 2 YA20 13(2) 3 YA35 18 30/11/07 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 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. Extracts may not be used or reproduced without the express permission of CSCI 5-7, Cedars Road DS0000017355.V351412.R01.S.doc Version 5.2 Page 26 - 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. 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