Inspection on 31/10/05 for 50 Fordbridge Road

This inspection was carried out on 31st October 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

50 Fordbridge Road 10/01/07

50 Fordbridge Road 18/05/05

50 Fordbridge Road 18/01/05

50 Fordbridge Road 08/06/04

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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 Fordbridge Road (50) 50 Fordbridge Road Ashford Middlesex TW15 2SP Lead Inspector Sandra Holland Announced Inspection 31st October 2005 10:30 Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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 Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fordbridge Road (50) Address 50 Fordbridge Road Ashford Middlesex TW15 2SP 01784 421223 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) fordbridge.rd@owl-housing.org Owl Housing Limited Ms Sarah Jean Dunningham Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (5), Mental disorder, excluding of places learning disability or dementia (1) Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the category of learning disability (LD) up to 5 (five) of the residents can be accommodated over the age of 65 years. Within the category of learning disability (LD) one resident can be accommodated with a mental disorder (MD) 18th May 2005 Date of last inspection Brief Description of the Service: Fordbridge Road (50) is a large detached house which can accommodate up to eight adults who have a learning disability. It is situated in an established residential area of Ashford with shops, leisure facilities and public transport available nearby. The registered provider for the service is Owl Housing and the premises are managed and maintained by Airways. The property is a two storey building and a lift enables service users to access all areas. There is a large garden with patio which can be accesed from the dining area or the lounge. Ramps and handrails are provided to support service users mobility. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the second to be carried out in the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006. This was an announced inspection, which means that everyone at the home should have been aware that it was to take place. To fully assess how the service has met the requirements of the National Minimum Standards (NMS), it will be necessary to read the reports of both inspections. Mrs. Sandra Holland, Regulation Inspector carried out the inspection. Mrs. Sarah Dunningham, Registered Manager was present on behalf of the home. The inspection took place over five hours and most areas of the home were seen. A number of records and documents were examined, including individual plans, tenancy agreements, staff files and training records. Further information was gathered from the pre-inspection questionnaires, which were completed and returned to CSCI. The eight service users living at the service were all spoken with or met with. As the inspector does not share the communication methods of some of the service users, their responses were gained by observing facial expressions and body language. More detailed information was provided by speaking to staff, from examination of records and from observing the relationship between service users and staff. Six members of staff were also spoken with. The people living at the home prefer to be known as service users and that is the term that be used throughout this report. The inspector wishes to thank the service users, staff and manager for their hospitality, time and assistance. What the service does well: The home successfully offers a high level of person centred support, which is specific to the needs of each individual. All service users are actively encouraged to be as independent as possible and to develop their skills. The accommodation is very well presented in an attractive, homely, style, whilst still providing for the needs of service users. It is clear that staff at the home are dedicated and committed to the support of the service users living there. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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 Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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 and 5. The home has a very detailed statement of purpose and service users’ guide. Each service user is provided with an agreement regarding their tenancy at the home. EVIDENCE: The manager stated that the statement of purpose and service user guide for tenants have recently been updated to make sure the information provided is correct. These also provide the information for prospective service users, to help them to decide if the home would suit them. A copy of each of these documents is displayed in the entrance hall at the home and a copy of each was supplied to CSCI, with the pre-inspection questionnaire. Each service user has a contract, which is known as a tenancy agreement and a statement of the terms and conditions for living at the home, the manager stated. These contained the required information, including the amount of fees charged for living at the home, the amount that is paid by the service user and the amount paid by anyone else, such as a local authority. The room to be occupied, the service user’s rights and responsibilities and the reasons for ending the agreement are also listed in the terms and conditions. They also state which things are not covered by the charges, such as hairdressing, chiropody and personal items. Where able, the service user has signed the tenancy agreement and the manager has signed on behalf of the home. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 9 Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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 and 10. An individual plan is drawn up to guide staff to the support needs of each service user. Information about service users is handled appropriately. EVIDENCE: A plan of the individual support needs for each service user has been drawn up and these have been updated to show the service users’ present needs the manager stated. This had been made a requirement at the inspection carried out in January 2005. The individual plans that were seen were in good order, contained the required information and had been regularly reviewed. A 24-hour support plan was in place for each service user and this describes all aspects of the service users needs throughout a 24-hour period. Assessments of any risks to the service users have been updated the manager stated. These were very detailed and included ways to prevent known risks happening and how to manage them. The manager advised that all risk assessments are now stored on the computer to make it easier to change them if needed. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 11 The manager stated that staff are told during their induction period, that they must keep all information about service users confidential. Staff read the confidentiality policy and sign to show that they have understood it and will follow it. Staff advised that handover meetings between staff are held in the office to ensure confidentiality. A staff communication book is used to pass information to all team members. Staff stated that they do not give information about service users to telephone callers, but pass this to the person in charge. Although a portable phone can be used in the home, all calls of a confidential nature are made or taken in the office for privacy. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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): 17. Service users are offered a healthy and balanced diet and enjoy their meals. EVIDENCE: The manager stated that service users make individual choices for their breakfast and lunch and that this is taken at a time of their choosing. The main meal of the day is served in the evening and is taken as a group. Service users are involved in the menu planning and pictures are sometimes used to assist service users in making selections. On the day of inspection, a small group of service users had gone out to lunch, following their morning activities. The remaining service users had lunch at the home and were enjoying their meal. Meals are served in the spacious, cheerfully decorated dining room, which is open plan to the kitchen. A large dining table provides space for all service users to eat together family style, and was attractively set with colourful tablemats. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 13 Staff stated that a record is kept of the meals each service user takes as this may differ from the planned menu. Service users are supported to make choices and to eat the food that they prefer. It was noted from the pre-inspection questionnaire, that a service user who prefers a vegetarian diet, was having the same food every Sunday for lunch. The manager stated that the chosen item was the service user’s favourite food and was served at her request. Other vegetarian options were available, the manager advised, if preferred. A selection of food was being prepared on the day of inspection for a Halloween party, to be held later that day. Paper napkins, plates and table decorations with a Halloween theme were provided and made a colourful display. (Music was provided by a service user, whose main hobby is disc jockeying). Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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): 21. The service aims to provide sensitive support until the end of life wherever possible. EVIDENCE: The manager stated that as a number of service users are becoming older and frailer, she has discussed with staff the differing support and care that will be needed. The manager has ordered an additional resource to assist with this and to raise staff awareness. A plan is held for each service user, to advise staff of the service users’ preferences for their funeral. This has been drawn up with the involvement of service users or from the knowledge of their preferences. These included the people to be involved, the preference for burial or cremation, preferred music and whether any religious service is to be involved. It was pleasing to see that service users were asked how they would like to be remembered and one service user has asked to be remembered with a disco. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. An effective complaints policy is available. Staff are aware of their responsibilities in the protection of service users. EVIDENCE: A detailed complaints policy has been produced in a picture format and a written format. This was available in the entrance hall and on the service user’s notice board in the dining room, along with the statement of purpose and service user’s guide. A shortened version of the complaints procedure in picture form, was available on the office door. The complaints record was seen and the last entry was made early last year. Beside the complaint, the action taken was listed and the entry had been signed. The manager stated that the complaint report form could also be used to make compliments to the home or to raise a concern. The statement of purpose advises that service users can raise any concern or complaint informally, to a member of staff at any time. Staff would usually report this to the manager, the appropriate support would be provided and the relevant procedure followed. Service users could also raise complaints or concerns at their individual action planning meetings or at service user group meetings. From speaking to staff and the manager, it was clear that staff are aware of their responsibilities to protect the service users. Staff are trained and given guidance from their induction, to be aware of abuse in all its forms and of the action to be taken, if abuse is suspected or occurs. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 16 Staff spoken to, stated that they would be willing and able to report any concerns they had. They said they would report their concerns to the manager or the deputy manager, if available and appropriate. In the absence of these people, staff would contact the on-call manager, who is listed in the office. Staff said they would also feel able to report to the area manager, who visits the home and is known to service users and staff. The home follows the Surrey Multi-Agency Procedure for the Protection of Vulnerable Adults and a copy of the procedure is kept in the home. The home also has its own policy and procedure, which refers to the multi-agency procedures of all local boroughs as the home borders two other boroughs, in addition to Surrey. For ease of reference for service users and staff, a number of Surrey contact telephone numbers are listed on the office door. Staff training records were seen to include the protection of vulnerable adults. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30. The bathrooms are suited to the needs of the service user and the home was clean and hygienic. EVIDENCE: Three bath or shower rooms are provided at the home. The two shower rooms are on the upper floor and one has been fitted to enable wheelchair access and has extra grab rails and non-slip flooring. The smaller shower room has been repaired to prevent water leaking into the surrounding wall. A spacious and warmly decorated bathroom is available on the ground floor and a built-in hoist provides easy access into the bath. All areas of the home were seen to be very clean, attractively presented and hygienic. The home had been seasonably dressed for the Halloween party, with balloons, banners and a variety of other decorations. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 18 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 and 35. The home carries out an effective recruitment procedure and staff are appropriately trained. EVIDENCE: Recruitment records were seen to contain all the required records and documents. All staff are required to undertake a Criminal Record Bureau (CRB) disclosure and these had been carried out. The manager stated that agency support staff are used from time to time to cover staff absences. She had obtained confirmation in writing, that the required records and documents are held for these staff, by the employing agencies. In the event that staff are employed to work on a visa arrangement, the manager stated that the human resources department (HR), keep track of the visa details and expiry date. The HR department ensure that staff renew any applicable visas, or they are not permitted to work for the organisation. Staff training records were seen, and covered legally required training and training to develop knowledge and skills. These included medication training, food hygiene training, first aid and fire training and the protection of vulnerable adults. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 19 The manager stated that staff are advised at the time of recruitment, that they will have to undertake training, specifically for the National Vocational Qualification (NVQ) and a specific induction for staff working with people with learning disabilities (LADAF). Two staff have nearly completed their NVQ Level 3 and two more staff will start this shortly. There have been difficulties in finding appropriate training providers, the manager advised. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 20 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): 39 and 43. A formal system of measuring the quality of the service needs to be set up. The service is managed competently. EVIDENCE: Although the quality of the service provided at the home is reviewed informally, during monthly visits under Regulation 26, and during monthly meetings with all service users, no formal system is in place for reviewing the service quality, the manager stated. Regulation 26 requires that an unannounced visit takes place once a month, to check on the standard of the service provided. The person carrying out the visit should speak to service users, staff and check the premises. They should leave a report at the home outlining what they have found. The manager stated that these visits take place and are carried out by a variety of people from the Owl organisation, including the relatives of service users. It is required that a formal system of review is in place and this must include all those involved in the support of service users, such as day service staff, Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 21 general practitioners (G.P.s), community nurses, community psychiatric nurses (C.P.N.s) and care managers. The manager stated that she receives regular information about the home’s financial performance, to assist her to manage the home’s budget. This information is supplied on a monthly and three-monthly basis and gives details of the income to the home and the expenses from the home. A monthly petty cash report is supplied by the home to the Owl organisation, which provides the detail of the home’s day-to-day expenses. When meeting with the finance manager, the home manager has the opportunity to discuss any financial issues, such as major repairs or extra staffing. The manager also discusses these issues with her line manager during supervision meetings, she advised. A requirement has been made. Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 22 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 3 x x x 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x x x 3 x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fordbridge Road (50) Score x x x 3 Standard No 37 38 39 40 41 42 43 Score x x 2 x x x 3 DS0000013514.V255005.R01.S.doc Version 5.0 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA39 Regulation 24 (1-3) Requirement The registered person must establish and maintain a system for the review and improvement of the quality of care provided at the care home. A report of the outcomes of the review of care must be supplied to CSCI and made available to service users. The review of the quality of care provided must consult with service users and their representatives. Timescale for action 27/01/06 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 Standard Good Practice Recommendations Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Fordbridge Road (50) DS0000013514.V255005.R01.S.doc Version 5.0 Page 25 - 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. 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