Inspection on 03/10/07 for 59, Lion Road

This inspection was carried out on 3rd October 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

59, Lion Road 18/08/06

59, Lion Road 04/11/04

59, Lion Road 08/06/04

59, Lion Road 27/11/03

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 59, Lion Road Twickenham Middlesex TW1 4JF Lead Inspector Simon Smith Unannounced Inspection 3rd October 2007 10:30 59, Lion Road DS0000017379.V353620.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 59, Lion Road DS0000017379.V353620.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. 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 59, Lion Road Address Twickenham Middlesex TW1 4JF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8891 6025 lion.rd@owl-housing.co.uk Owl Housing Ltd Ms D Brenner Adi Anderson Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Physical disability (8), of places Physical disability over 65 years of age (8) 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th August 2006 Brief Description of the Service: 59 Lion Road is home to eight people who have learning and physical disabilities. The home is also registered to accommodate people over the age of 65. Residents’ fees are £1320 per week. All placements are funded by the London Borough of Richmond. The service is managed by Owl Housing Limited and the property is managed by the Metropolitan Support Trust. The property is situated in central Twickenham, close to shops, public transport and other local amenities. 59, Lion Road DS0000017379.V353620.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 deputy manager. Some written information was checked, including residents’ files and health and safety records. The inspector was made welcome during the visit and wishes to thank all those who gave their views about the home. Surveys were given to residents, staff and relatives. Four staff, one resident and one relative returned surveys to the CSCI. The resident said that they like living at the home and feel safe and well cared for. The resident also said that staff treat them well and that they can have privacy when they want it. The relative said that the home helps residents keep in touch with their families and supports people to live the life they choose. The relative commented, “The home does well for the people they look after. They take them out to the shops, out for walks, to the River and the Green”. Staff said that they had an induction when they started work and good support to do their jobs. Comments made by staff included: “The manager and the deputy support me by arranging monthly supervision” “My induction covered all the necessary training I needed for my work” “We have written procedures and there are clear guidelines in place” “There is a weekly staff meeting where we discuss issues affecting the staff and most importantly the service users. We also discuss what we need to do to improve the service”. The manager and many of the staff team have worked at the home for some time and know residents’ needs well. The home had three staff vacancies at the time of inspection. The deputy manager said that one new member of staff had been appointed and was waiting for clearance to start work. The home met 29 of 32 National Minimum Standards assessed at this visit. Two Standards were exceeded and one Standard was almost met. What the service does well: There is a stable management and staff team that provides consistently high quality care. Residents receive an individualised service according to their needs and preferences. Care plans are person-centred and regularly reviewed. 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 6 There is a commitment to seeking residents’ views and to acting on what residents say. Residents receive good support to maintain relationships with their friends and families. Any changes in residents’ needs are effectively identified and addressed. Staff know residents’ needs well and follow guidelines about residents’ care accurately. Staff work co-operatively with other professionals in delivering residents’ care. The manager provides effective leadership and good support to staff. Staff have access to good training opportunities. 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. 59, Lion Road DS0000017379.V353620.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 59, Lion Road DS0000017379.V353620.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, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written information about the home is available to residents. Residents’ needs are effectively assessed. Residents are able to visit and stay at the home before deciding to move in. Residents are issued with a written agreement that sets out the terms and conditions of their placement. EVIDENCE: The home has a Statement of Purpose, which outlines the service and includes the Complaints procedure. There is also a Tenants’ Handbook, updated in February 2007, which sets out residents’ rights and responsibilities. Each resident has a Tenancy Agreement, which outlines the terms and conditions of residency. Staff said that the manager assesses all prospective new residents to establish whether the home can meet their needs. Following an assessment, one 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 9 resident moved into the home in July 2007. The resident had a series of visits before deciding to move to the home, including an overnight stay. The resident was accompanied at first by staff from his previous home, who worked with staff from Lion Road. The resident was supported to maintain his existing day service and has had a review since he moved in. 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans record residents’ needs and strengths and provide guidance for staff delivering care. Care plans are person-centred and regularly reviewed. Residents receive good support to make choices about their lives. The home supports residents in taking manageable risks. EVIDENCE: Each resident has an Essential Lifestyle Plan, which contains individualised information about their strengths and needs and makes good use of photographs to illustrate how residents spend their time. Residents’ plans also identify important people in their lives and contain good information about 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 11 individual preferences in terms of daily living. There was evidence that care plans are regularly reviewed and updated. Plans also contained monthly summaries, put together by the resident’s key worker, which address any healthcare issues, day services, social activities and contact with friends and families. The home carries out appropriate risk assessments to enable residents to take risks as part of an independent lifestyle. The risk assessments checked identified clear control measures and contained evidence of regular review. Staff on duty demonstrated a good knowledge of residents’ needs and a commitment to supporting residents in making decisions about their lives. For example one resident made a choice about his diet when he moved in from another placement, which was well supported by the home. The service consults significant others, such as family members and care managers, about residents’ care where appropriate. 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. 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 their local community. Residents receive good support to maintain relationships with their friends and families. Residents’ rights and responsibilities are recognised in their daily lives. Residents are consulted about the home’s menu and receive a balanced diet. EVIDENCE: 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 13 Residents have individualised programmes of activities and are involved in their local community. Staff said that residents enjoy visiting Twickenham and Kingston and residents’ care plans provided evidence of activities and community participation. Residents have the opportunity to take an annual holiday and groups from the home had visited Blackpool and Bognor Regis in 2007. Three residents use a local resource centre regularly. The deputy manager said that a link worker from the resource centre works with residents and their key workers to plan residents’ individual programmes. Some activities are available to residents at home. For example an aromatherapist visits twice each week to work with all residents. Residents receive good support to maintain contact with their friends and families. Staff said that all residents have some family contact and that some residents go to church regularly. Staff support residents to visit their families if they are unable to come to the home. For example one resident is supported to visit his family in Bournemouth. One resident was visited by her sister on the day of inspection. Residents have unrestricted access to all communal areas and are able to choose how they spend their time at the home. Staff demonstrated a commitment to promoting and protecting residents’ rights. Residents have access to independent advocacy services. Residents are able to contribute to the home’s menu, which rotates on a fourweek cycle. The menu indicated that the home provides a varied and wellbalanced diet. Responsibility for cooking and preparing food is shared amongst the staff team. All staff undertake basic food hygiene training as part of their induction process. 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents receive preferences. individualised support according to their needs and Any changes in residents’ needs are effectively identified and addressed. The home works co-operatively with other professionals in delivering residents’ care. Residents’ medication is appropriately stored and recorded. EVIDENCE: The home provides residents with excellent support to maintain good health. The inspection provided evidence that the home liaises well with healthcare professionals when necessary and responds appropriately to any changes in residents’ needs. Residents attend regular health checks and any issues arising are referred to the resident’s general practitioner. 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 15 Guidelines for the delivery of individual care are in place and staff follow these guidelines accurately. Staff have also had training in areas where residents have specific needs. For example an occupational therapist provided training for staff in supporting residents who need assistance with feeding. All staff have moving and handling training and instructions in how to use the equipment at the home. There is an appropriate system for storing medication and a senior member of staff has responsibility for this area. There are clear procedures governing the administration of medication and home has an arrangement with a pharmacist for advice about medication and an annual inspection. Medication records for three residents were checked and found to be accurate. No residents self medicate. 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. 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. Appropriate procedures are in place for the management of complaints. Training is provided for staff in the recognition, prevention and reporting of abuse. EVIDENCE: Owl Housing has a written Complaints procedure. There have been no complaints about the home. The service works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’. The policy offers definitions of abuse and provides guidance for staff in the recognition and reporting of abuse. Staff attend training in the Protection of Vulnerable Adults during their induction and go to regular refresher training. There was evidence that the home obtains Criminal Records Bureau disclosures for people who work with residents. 59, Lion Road DS0000017379.V353620.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, 28, 29 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 maintained. The communal rooms of the home are comfortable and homely. Residents’ bedrooms reflect individual preferences. Specialist equipment has been installed where necessary. The home is clean and hygienic. EVIDENCE: The home is situated in central Twickenham with good access to local community facilities, open spaces and public transport networks. There is some 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 18 off-street parking at the side of the home and a well maintained garden to the rear. The communal rooms include a large lounge, separate dining room, kitchen and a quiet room with a sensory area. Residents’ bedrooms vary in size and shape but all those seen were comfortable and personalised. Specialist equipment has been installed where necessary, including baths and beds, to meet residents’ needs. There are portable and fixed track hoists to assist residents to mobilise. 59, Lion Road DS0000017379.V353620.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, 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. Job roles within the service are clear and defined. Staff are appointed following an appropriate recruitment and selection procedure. Staff attend training appropriate to their roles. Staff receive good supervision and support. EVIDENCE: All new staff have an induction when they start work and those on duty said that the induction they had was good. Staff work to a clear shift plan and each shift has an allocated leader. Staff have specific training for this role. Staff said they work well as a team and that they meet as a group every week. 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 20 There were three vacancies on staff team at the time of inspection. One new member of staff had been appointed and was awaiting clearance to start work. Interviews for the other vacancies were to take place shortly after the inspection. The deputy manager said that the home was covering the vacancies with regular bank and agency staff. Staff are recruited through a recruitment day and formal interviews. Owl Housing’s Human Resources department provided evidence that the organisation carries out appropriate pre-employment checks on staff, including Criminal Records Bureau disclosures. Staff said that they have good access to training opportunities and regular refreshers in core areas including fire, health and safety, moving and handling and food hygiene. Two staff had just started NVQ level 3 and most other staff have achieved this qualification. All staff have regular individual supervision, which is shared between the manager and deputy manager. Staff said that the manager provides good support to the team. One member of staff said “He is very available. He really guides and supports us. He treats everyone as an equal”. 59, Lion Road DS0000017379.V353620.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 good. This judgement has been made using available evidence including a visit to this service. The manager provides effective leadership and good support to staff. Staff feel able to contribute their ideas about how the home is run. There is a commitment to seeking residents’ views and to acting on what residents say. Standards of health and safety are generally good but the home should review the fire risk assessment. EVIDENCE: 59, Lion Road DS0000017379.V353620.R01.S.doc Version 5.2 Page 22 The manager has significant experience in his role and has achieved relevant qualifications. Staff said that the manager is supportive and encourages their input in the running of the home. One member of staff said, “You are free to raise anything. There is action taken about any comments or complaints”. There is a commitment running the service in regularly, supported by relevant stakeholders as to seeking residents’ views about the home and to their best interests. Residents meetings are held staff, and Owl Housing surveys residents and other part of the organisation’s Quality Assurance process. Portable appliance testing was last carried out in February 2007 and the Landlord’s Gas Safety Certificate was issued in April 2007. The home’s hoists were checked in November 2006 and the lift was serviced in September 2007. The home has valid Certificate of Employers Liability Insurance. All accidents and incidents are recorded. Staff check water temperatures regularly. In two residents’ bedrooms the temperatures recorded were consistently above the limits outlined in the National Minimum Standards. The home must ensure that hot water temperatures are not significantly above 43°C at the point of delivery. See Requirement 1. Staff check the fire alarm system weekly using different call points. The home’s fire fighting equipment was checked in May 2007 and the last fire drill took place in October 2007. The fire alarm system and emergency lighting were professionally examined in May 2007. There was a fire risk assessment on file, dated June 2004. Given the time that has elapsed since this date, it is recommended that the risk assessment be reviewed. 59, Lion Road DS0000017379.V353620.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 3 5 3 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 X 28 3 29 3 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 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 3 3 X X 2 X 59, Lion Road DS0000017379.V353620.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 YA42 Regulation 13(4) Timescale for action The Registered Person must 30/11/07 ensure that hot water temperatures are not significantly above 43°C at the point of delivery. Requirement 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 YA42 Good Practice Recommendations It is recommended that the fire risk assessment be reviewed. 59, Lion Road DS0000017379.V353620.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 59, Lion Road DS0000017379.V353620.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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