Inspection on 16/10/07 for 65 Gloucester Crescent

This inspection was carried out on 16th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

65 Gloucester Crescent 08/03/07

65 Gloucester Crescent 06/06/06

65 Gloucester Crescent 23/08/05

65 Gloucester Crescent 18/04/05

65 Gloucester Crescent 12/11/04

65 Gloucester Crescent 15/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Gloucester Crescent (65) 65 Gloucester Crescent Laleham Middlesex TW18 1PN Lead Inspector Tina Thomas Unannounced Inspection 16th October 2007 10:30 Gloucester Crescent (65) DS0000013528.V351396.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 Gloucester Crescent (65) DS0000013528.V351396.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. Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gloucester Crescent (65) Address 65 Gloucester Crescent Laleham Middlesex TW18 1PN 01784 421407 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) gloucester.ct@owl-housing.org Owl Housing Ltd Ms Roisin Donnelly Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The age/age range of the persons to be accommodated will be: Under 65 years, with the exception of one person who may be over 65 years Manager works full time and is supernumerary to care staff at all times That a management structure is in place where a suitably trained and experienced deputy for each home is named for Service Use and staff at all times. That a management structure is in place where a suitably trained and experienced deputy for each home is named for Service Users and staff at all times. Management of the homes will be formally reviewed on an annual basis, to ensure management requirements of both services are met by the arrangement. 8th March 2007 4. Date of last inspection Brief Description of the Service: 65, Gloucester Crescent is a home for 6 residents with a learning disability. The home is situated across the road from another Owl Housing Ltd home and residents from both homes meet up regularly and often share the same staff team including the manager, who is registered for both homes. The home offers accommodation for single occupancy with bedrooms on the ground and first floor of the detached property. Car parking is available on the road. Transport is available for residents to go out. Current fees range from £1,143 onwards. Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process took place over a period of time, information was gathered, and it concluded with an unannounced site visit. This means that people at the home including the staff did not know the inspection was going to take place. The inspection looked at key standards. Judgements were made by taking into account evidence from a range of documentation including a tour of the home, views of people living at the home, and discussion with the Manager. The Homes AQAA (annual quality assurance assessment) also produced evidence for this inspection. What the service does well: What has improved since the last inspection? What they could do better: Staff should be trained to NVQ Level 2 or above. The kitchen work top surface is aged. The home should plan to renew/repair this. Some redecorating continues to be outstanding. Please contact the provider for advice of actions taken in response to this Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 6 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. Gloucester Crescent (65) DS0000013528.V351396.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 Gloucester Crescent (65) DS0000013528.V351396.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home supplies sufficient current information for people choosing to live at the home, their relatives or Commissioners of services to make an informed decision regarding what the home has to offer on a day to day basis. EVIDENCE: The home has a current Statement of Purpose and Service User Guide. This information allows people to make an informed decision regarding admission to the home. The service user guide is in pictorial form to aid people living at the home or people considering living at the home, who prefer this method of communication to understand what can be expected in day to day life at the home. The home has a thorough and holistic admission process for any new admissions to the home. The home has had no recent admissions. Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 9 Gloucester Crescent (65) DS0000013528.V351396.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): 6,7,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care planning is person centred. Communication methods are clearly documented for . people with limited verbal communicators. Decision-making processes are well documented. Risk assessments maximise the capacity of people at the home to be independent. EVIDENCE: Each person living in the home has a care plan. Care plans are very clearly produced and easy to read. Care plans contain relevant pictorial aids. Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 11 ‘Essential Living Plans’ also featured recent photos that helped inform staff of the service user’s character and individuality. These had been thoughtfully put together so that people could relate to their daily living plans. Peoples routines were well documented and ensured that staff knew how to help people to do things at certain times of the day, such as sitting in the kitchen while the evening meal is cooked. Care plans clearly documented peoples likes and dislikes ie getting up in the morning, meals. For people in the home who had limited verbal communication, there was instruction for staff ie ‘When I do this I mean this’. For other people there were instructions ie ‘when I say this I mean this.’ Robust risk assessments were in place. Staff guidelines were available for each person relating to how they made choices and sometimes put themselves at risk. Details of what staff should do at these times were well detailed. A clear assessment system and scoring chart was in place for everyone. A staff ‘Handover Checklist’ contained details of emergency contact numbers, front door keys, how to support people by noting the ‘behavioural guidelines’ listed in their care plan folder. Consideration of peoples hopes, dreams and aspirations were taken into account in their plan of care. Gloucester Crescent (65) DS0000013528.V351396.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): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are available and the programme of activity is actively evolving to increase opportunities and include people living in the home in decisionmaking. Some service users have regular contact with family and friends. Service users are offered a healthy diet. EVIDENCE: People at the home are generally assisted by the staff to find suitable and meaningful activities. Some people go to day centres. Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 13 Activities are age and gender specific. A party from the home regularly attend a night club. It was at the night club that staff found that one young person enjoyed and responded to rap music. They were supported to purchase music of this type and continues to enjoy it. People at the home also enjoy aromatherapy on a weekly basis. People at the home are supported to maintain contact with relatives and this is described in their care plans. Some go out to lunch with relatives and the staff. Sometimes people in the home are supported to telephone their relatives and friends. The home has a mini bus and two employed drivers. Staff assist people at the home to maintain links with the local community. People living in the home can generally choose when to get up and go to bed, whether to go out or stay in – the home’s daily routines are organised around this, accepting some would have day centre or other commitments. Staff are respectful at all times to the people living in the home. Some people have, and use, the key to their own rooms. The staff conduct well-documented nutritional assessments for each person living in the home. Records regarding food intake and enjoyment are of good quality. A range of snacks and drinks are also available at all times. Menus are pictorial to help people understand what they are choosing. There is a choice of meals at each mealtime. The manager recognises in the home AQAA that further activities could be offered if staffing levels were higher. Gloucester Crescent (65) DS0000013528.V351396.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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support needs are clearly documented. Staff are consistent in their approach. Physical health needs are generally well met and medication management is sound. EVIDENCE: Staff were seen to support people living at the home with dignity and inline with their care plans. The home has a key worker system and the induction of new staff includes personal care issues. People’s health care needs are addressed in their care plans. As previously mentioned they have access to other health care professionals. Peoples care plans contained evidence of staff commitment to support and protect their healthcare needs. Recognition of service users’ difficulties in Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 15 maintaining a healthy diet was dealt with sensitively and there was evidence of strategies being discussed. Full healthcare details such as diabetes care, epilepsy, hay fever and mobility were available in the service users’ care plan folders and clearly described what actions needed to be taken in the event of an attack and listed the appropriate risk assessment and response for service users and staff. Support from other health care professionals ie district nurse, epilepsy nurse, OT were clearly identified. The home has improved its procedures regarding the administration of medication. Staff are trained by a trainer in the administration of medication and the Owl pharmacisit. Medication procedures are audited on a monthly basis. Gloucester Crescent (65) DS0000013528.V351396.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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The company has a complaints procedure, which is available in accessible formats to meet the special requirements of the people living in the home. Staff are aware of adult protection issues. Staff endeavour to protect the dignity of the people living at the home. EVIDENCE: The home has an updated complaints policy and procedure. The complaints procedure is in several different formats so that people at the home can understand it. People that live at the home have an opportunity to raise complaints with their key workers if they choose. The manager speaks to each person living in the home on a daily basis, when she is on duty. Staff undertake adult protection training. There have been three complaints investigated in the past year, which have not been upheld. There are currently no complaints being investigated. Gloucester Crescent (65) DS0000013528.V351396.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): 24,25,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally clean and free from odours and fit for purpose. The home has undergone a lot of redecoration. A few areas continue to need some improvement. Peoples own bedrooms are generally comfortable and well decorated and furnished. EVIDENCE: Furnishings are domestic in style, and comfortable. Residents have a choice of communal areas. There has been an ongoing programme of redecoration in the home. Some areas have been redecorated whilst other areas are still in need of Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 18 redecoration. This is purely cosmetic and does not pose health and safety issues to staff or people living in the home. The manager is aware that there are areas that still need redecorating. This will be included in the homes annual development plan. All people living at the home have their own bedrooms. Peoples own rooms have been painted and new flooring has replaced the old carpets. Bedrooms reflect the personalities of the people they belong to. The kitchen is very aged, although staff have tried to keep it clean. The home is generally clean and free from offensive odours. Gloucester Crescent (65) DS0000013528.V351396.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): 31,32,34,35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People at the home are supported by staff that understand and react appropriately to their needs. Recruitment practices at the home ensure the safety of the people that live there. Staff are generally well trained, although numbers of staff trained in NVQ Level 2 in Care, fall short. EVIDENCE: Staff were observed to have a good knowledge of the needs of the people they were supporting. They were respectful and consistent in their approach. All staff including regular bank workers undertake a Learning Disability Awards Framework (LDAF) induction and foundation training at commencement of employment. They also undertake an Owl Housing induction. Staff undertake mandatory training and some service specific training. However, according to the homes AQAA less than the required 50 of care Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 20 staff are trained to NVQ Level 2 or above. The manager should ensure that this is achieved. Owl Housing Association’s own bank staff supplement staff whenever permanent staff are not available or if additional care needs arise. The manager reflected that staffing was at a better level now that there were only five people living at the home. One staff file was viewed although generally these are kept at head office. The staff file showed that the home has robust recruitment procedures that are adhered to, and are in line with regulation. This helps to keep people safe. Gloucester Crescent (65) DS0000013528.V351396.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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. The home’s quality assurance processes and internal auditing identify the home’s strengths and weaknesses. People living at the home are enabled to influence the running and routines of their home. The health, safety and well being of people in the home is observed. EVIDENCE: The registered manager had completed her National Vocational Qualification Level 4 in Home Management. Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 22 At the last inspection a home improvement action plan was in place listing named staff responsible to meet the timescales of the improvements to the home and the range of home improvements. The home has met many of its objectives. The manager has completed an annual quality assurance assessment. This demonstrates that she has already recognised many of the strengths and weaknesses of the home. She has looked at what the home still needs to do and how she and Owl housing intend to do it. People living at the home are able to affect the running of the home through residents meetings. The home actively seeks the views of people that live in the home. It was recommended at the last inspection that the home replace the worn kitchen worktop, this has not yet been completed. Generally the health, safety and well being of people in the home is well observed. Gloucester Crescent (65) DS0000013528.V351396.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 x 2 x 3 3 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 2 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 3 32 2 33 34 35 36 4 4 x 4 x LIFESTYLES Standard No Score 11 12 13 14 15 16 17 x 3 3 x 3 3 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000013528.V351396.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gloucester Crescent (65) Score 3 3 3 x 3 x 3 x x x 3 Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 YA38 Good Practice Recommendations It continues to be recommended that the home replace the worn kitchen worktop. Gloucester Crescent (65) DS0000013528.V351396.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Gloucester Crescent (65) DS0000013528.V351396.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. 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!