Inspection on 21/10/08 for 79 Harrow View

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Excellent service.

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

79 Harrow View 04/01/07

79 Harrow View 14/12/05

79 Harrow View 18/05/05

79 Harrow View 06/01/05

79 Harrow View 29/06/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 79 Harrow View 79 Harrow View Harrow Middlesex HA1 4TA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judith Brindle     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: 79 Harrow View 79 Harrow View Harrow Middlesex HA1 4TA 02088630981 02088610735 hm79harrow@supportforliving.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Sean Robert Mathew Brown Type of registration: Number of places registered: Support for Living (Harrow) care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home 79 Harrow View is a care home providing care, support, and accommodation for 9 adults who have mental health needs. Support for Living (Harrow) is the proprietor of the care home. The Family Welfare Association is the care agent and employs the staff. Paddington Churches Housing Association owns the property. The registered care home was opened in 1988. The home is located in a residential area close to central Harrow. It is a large semi-detached house and consists of three floors. The home is within a few minutes walk from a variety of amenities, which include shops, banks, restaurants, Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 9 Brief description of the care home parks and leisure services. There are accessible train, and bus public transport facilities close to the care home. The residents bedrooms are single, and are located on each floor. Communal space includes two sitting rooms, and a kitchen dining area. The home has a garden, which is enclosed, well maintained, and accessible to residents. The home has accessible information about the care home and the service provided. Information with regard to the fees is accessible from the service. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection took place throughout a day in October 2008. There were no vacancies at the time of the inspection. We were pleased to meet and talk to all the people living in the home. The registered manager was present during most of the inspection. A number of feedback surveys were supplied to the care home prior to the inspection. At the time of writing this report the Commission for Social Care Inspection had received three surveys from people using the service, and two from staff. Documentation inspected included, residents care plans, risk assessments, staff training records, and some policies and procedures. The inspection included a tour of Care Homes for Adults (18-65 years) Page 6 of 33 the premises, and observation was also significant tool used in the inspection process. Assessment as to whether the requirements and the recommendations from the previous key inspection (4th January 2007) had been met, also took place during the key unannounced inspection. 26 National Minimum Standards for Adults, including Key Standards, were inspected during this inspection. Prior to this unannounced key inspection the registered manager supplied the Commission for Social Care Inspection a completed Annual Quality Assurance Assessment (AQAA) document. This record includes required information from the registered manager about the quality of the care home, and the planned improvements for the service. This document had been completed comprehensively. Reference to some aspects of this AQAA record is documented in this report. The inspector thanks the people living in the care home, staff and the manager for their assistance in the inspection process. What the care home does well: What has improved since the last inspection? The three requirements, and the recommendations from the previous unannounced Care Homes for Adults (18-65 years) Page 8 of 33 inspection (4th January 2007) have been addressed. The recording of incidents now include outcomes, and two maintenance issues have been resolved. The care home has continued to provide a quality service to residents. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service have the information needed to choose a home that will meet their needs. Prospective residents have their needs assessed, with their full participation, prior to moving into the care home, which makes certain that the home knows about the person, and the support that they need. Evidence: The home has an accessible up to date service user guide and statement of purpose which include information about the service provided by the care home. We were told that the service user guide is in the process of being comprehensively reviewed by the people using the service, with support from and a work placement student, and staff team. We were informed that this task was being completed with the aim of improving the format of the document, and to ensure that the service user guide includes the views of residents about the service provided to them. This is positive. The home has an assessment and referral policy. AQAA (Annual Quality Assurance Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: Assessment) information told us that this had been reviewed in March 2008. There has been one new resident admitted to the care home since the previous key unannounced inspection. We were told that following a referral from a Local Authority, (which includes a copy of a care management assessment), the prospective resident has their needs comprehensively assessed by staff, including the manager. We were told thats assessment of the persons needs involves full participation from the prospective resident. A person using the service spoke of being involved in this assessment process. A completed initial assessment was available for us to look at. It was evident that this assessment focuses on achieving positive outcomes for the prospective resident. AQAA and staff told us that people living in the home are informed of the referral process and that they are invited to comment or make clear any concerns they may have about a prospective resident moving into the care home. It was evident from the AQAA and from talking to staff that they were fully aware of the anxiety that a prospective resident (and the people using the service) might feel throughout the process of moving into the care home. Staff and a resident informed us that significant time, and effort is spent planning to make admission to the home personal and well managed. There is a high value on responding to individual needs for information, reassurance and support. We were told by staff, records and a person using the service that the referral and transition process is flexible in accordance with the needs of the prospective resident. The number and kind of visits to the care home are discussed and agreed with the person. A resident spoke of visiting the home several times before the person decided to move into the home. This person using the service confirmed that it had been their choice to live in the home that it met their needs, and that they were happy living at 79 Harrow View. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service know that their assessed needs, changing needs, and personal goals are reflected in their individual plan of care. They play an active role in planning the care and support they receive. People using the service are supported and encouraged to make decisions and choices about their lives, and are supported to take risks as part of an independent lifestyle. Evidence: Each person using the service has a personal development plan (care plan). A resident kindly showed us her plan of care. She told us that she regularly met with her key worker to discuss her needs and goals. Three personal development plans were looked at. It was evident that people using the service are involved in the development of their plan of care, and support, and that each personal development plan is based upon assessment of the persons needs, and that care plans are working tools. The personal development plans focus on each Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: persons strengths and needs and personal preferences. They include a range of information that is important to them. This includes goals, and aspirations, how to keep safe, and information about their health. It is clear that the service (including the resident) works actively with other services and organisations to ensure that the whole persons life needs are met, and personal goals addressed. Residents, staff, and the care plan records told us that the personal development plans are regularly reviewed with the person using the service, including when their needs change. These plans include information about the persons health, skills, abilities, emotional, social needs, and aspirations, as well as guidance to ensure these needs are met through positive individualised staff support. These documents and AQAA information told us that the equality and diversity needs of residents are understood and supported by the service. Records, and staff confirmed that there is significant preparation carried out with individual residents prior to regular review meetings, and when meeting with health care professionals including psychiatrists. The manager told us that the residents are supported to communicate their views about their health needs, and that people using the service generally take a pro active role with regard to communicating their needs during these meetings. This is positive. People using the service spoke positively about the staff. They confirmed that their key workers actively provide one to one support, and assist in keeping the residents individual plan of care and support up to date. Regular one to one key worker meetings take place. A resident participated in a key worker meeting during the inspection. This person using the service was clear about the arrangements for the planned meeting and confirmed that they wished to take part in the meeting. Staff who spoke to us had knowledge, and understanding of their key worker role. AQAA documentation told us that people using the service have the opportunity to change their key working arrangements if they wish. It is evident that staff are committed in supporting individuals to lead purposeful, and fulfilling lives as independently as possible. The personal development plans that were looked at, included comprehensive risk assessment. These risk assessments include medical, physical, and social needs. We were told that residents are fully involved in the development and review of their risk assessments. It was evident from talking to people using the service and staff that the service has a can do attitude, and risks are managed positively to support people using the service to lead the life that they want. Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: People using the service told us that they are supported to make decisions about their lives, and are consulted with regard to how the service runs, and on its future development. People using the service confirmed that they were listened to, and that choices that they made were respected by staff. Residents have the opportunity to attend regular community meetings, which are chaired and minuted by themselves. Residents kindly spoke of decisions that they regularly made about their lives. We were told that people using the service are now involved in the process of selecting new staff. Also that they have the opportunity to attend away days , during which they can discuss a number of issues about the service. It was evident from speaking to staff, residents, and from records that the care home acts upon the results of consultation with people using the service. Each resident has a key to their bedroom, and the front door. A resident spoke of the importance to him of being able to lock his bedroom door. Staff were observed to knock on bedroom doors. From talking to people using the service, records, and staff it is evident that the service has a commitment to promoting dignity, valuing diverse needs, and has a positive, innovative approach to care practises. Residents and staff told us that people using the service manage their own finances. Care Homes for Adults (18-65 years) Page 15 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle, and are supported to develop their life skills. Social, educational , cultural, and recreational activities meet individuals expectations. The people living in the care home have their rights respected, and their responsibilities are recognised in their daily lives. Meals are varied and wholesome, and meet the cultural and religious needs of people using the service. Evidence: People using the service told us about the activities that they participated in and enjoyed. These activities included being involved in various work projects. Two residents spoke of the gardening project that they participated in and enjoyed. A person using the service told us of the horticultural qualification that they had recently Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: achieved. We were told that a person using the service has paid employment to carry out domestic cleaning duties within the home. He spoke of enjoying his job. AQAA told us that another resident has a cleaning job, which (the person) accessed through family support. AQAA documentation also told us that several residents are keen to develop their access to supported employment activities within the locality, but that these opportunities are limited within then Harrow area. Another resident spoke of the computer training course, and the language course that they enjoyed. We were told that some residents attend local day services several times a week. It was evident that activities and leisure pursuits are flexible and chosen by the people using the service. Residents spoke of their community participation, including accessing amenities, and facilities in Harrow, such as shopping, going to restaurants, and of regularly using the local post office. A person using the service went to an exhibition in London during the inspection, which the person spoke of enjoying. A person using the service spoke of going to the theatre and opera regularly. Residents spoke of their involvement in all areas of daily living responsibilities in the home. This includes carrying out personal planning of meals, food shopping, buying clothes, and doing their own personal laundering of their clothes. Residents have a pet cat. A resident spoke positively of the cat and told us of how they care for the pet. People using the service spoke of recent holidays that they had enjoyed. It is clear that the service actively encourages, enables, and supports people using the service to participate in varied opportunities to develop, and maintain their social, emotional, and independent living skills where appropriate. Central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life, in both the home and community, and to enjoy all the rights and responsibilities of citizenship. It was evident from talking to people using the service, staff, and assessment of records that the service actively promotes the importance of respect, equality, dignity and autonomy. The visitors book confirmed that there visitors to the care home. It was evident that the home supports residents to develop, and actively maintain relationships (if they wish) with family and friends. We were informed by staff that people using the service have varied contact with relatives and or significant others. A resident spoke of regularly staying with relatives. A person using the service spoke of celebrating religious festivals with family and friends. We were told that some residents enjoy cooking, and eating together, and that others have chosen to prepare their own meals. Meals that are prepared by, and cooked for a number of residents are chosen by them during their community meetings. Residents spoke of going shopping to buy fresh ingredients for meals that they plan to cook for themselves. A person using the service Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: confirmed that planning and preparing their meals was the residents choice, and suited them. Another resident told us that there were always a number of spices, and ingredients that she could access to make the meals that she liked. It was evident that the dietary cultural needs of residents were being met by the service. A cookery club takes place regularly to introduce and cook chosen dishes. There continues to be weekly shopping for general ingredients and other household items, which is organised and carried out by people using the service. A person using the service spoke of shopping at a local supermarket for food items. Care Homes for Adults (18-65 years) Page 18 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, and personal care that people receive is based upon their individual needs. The principles of respect, dignity and privacy are put into practise. Systems are in place to ensure that medication is stored and administered safely to people using the service. Evidence: It was evident from talking with staff, residents, observation and records that people using the service and, staff have knowledge, and understanding of the importance of ensuring that the residents have their health care needs assessed (with their full participation) and met. Treatment, and care for residents from health care professionals including the GP, dentist, psychiatrist, and optician, were recorded. Attendance at specialist clinics, and hospital clinics were also documented. It was evident that advice was sought by people using the service as, and when required from health care professionals, and that referrals were made in accordance to residents needs, and their changing needs. A Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: resident spoke of the regular dental care that he receives. Another resident told us that they organise their own health care appointments, with some staff support. It was evident from talking to people using the service, and staff, that residents are involved fully and are supported in the planning and attendance of health and social care appointments, including appointments with specialist health care professionals. The home has a medication policy. Medication is stored securely. The medication storage, and administration systems were inspected. Medication administration records were up to date, and had no gaps in recording. Records and staff told us that a pharmacist regularly inspects the medication storage and administration systems in the care home. The care home has a sustained record of compliance, with safe storage, and medication administration procedures. Staff spoke of the medication training that they received. Residents, staff and records told us that the home strongly promotes residents independence with regard to medication administration,. Several residents have been assessed as being able to self administer their medication. These residents are encouraged, and supported by staff to manage their own medication. Care Homes for Adults (18-65 years) Page 20 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to an effective, robust complaints procedure, and are protected from abuse, and have their rights protected. Evidence: The care home has a complaints procedure, a summary of which is recorded in the service user guide. The complaints procedure includes timescales with regard to responding to a complaint. AQAA information told us that all the people using the service had been given copies of the complaints procedures. We were also told that complaints is an agenda item that is brought to residents community meetings, and that residents have the opportunity to discuss concerns and complaints during their one to one key worker meetings. The manager told us that when people using the service communicate a concern or complaint, they are fully informed of the complaints procedure, and are kept informed of any action taken in response to their complaint or a concern. Residents feedback surveys confirmed they know who to talk to if they are not happy. AQAA information told us that there had been one complaint received within the last twelve months, which had been resolved within 28 days. Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: AQAA information told us that the care home has plans to ensure that residents feel more involved and responsible for all parts of the service, including complaints, and protection, and that during the review of the service user guide, the complaints procedure summary will also be reviewed. It was evident from talking to people using the service, and staff that the care home has a positive culture toward complaints, and suggestions about the service, and that the service recognises the value and importance that they bear in driving the service forward and in protecting individuals. The home has clear, and robust policies, and procedures with regard to the protection of people using the service, and has a copy of the local authority safeguarding adults guidance. The staff who spoke with us had an awareness, and understanding of the reporting, and recording procedures with regard to responding to concerns or complaints, and any suspicion or allegation of abuse. Staff and records told us that all staff had received training in safeguarding adults, and that safeguarding is included in the staff induction programme. The service has continued (as required) to inform the Commission for Social Care Inspection of all notifiable events, and of the action taken by the service in response to incidents. AQAA information told us that the home has a whistle blowing policy, equal opportunities, diversity, and anti-oppressive practise, and counter harassment policies. Care Homes for Adults (18-65 years) Page 22 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The layout of the home enables residents to live in a safe, generally well maintained, warm, clean and comfortable environment, which encourages independence. Residents bedrooms, meet their individual needs, and are personalised. Evidence: The care home is in keeping with other houses in a residential area. It is located close to the variety of amenities, and public train and bus transport facilities of central Harrow. Residents spoke of liking the location of the home, and told us of the positive aspects of being able to walk to Harrow. A person using the service spoke of accessing local shops. The inspection included a tour of the premises. A person using the service kindly showed the inspector around the home. The care home is generally well maintained, homely, clean and airy. Feedback surveys from people using the service confirmed that they thought that the home was fresh and clean. The living environment is appropriate for the particular lifestyle, and needs of people living in the home. Houseplants, ornaments, photographs, pictures, televisions, and Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: music systems are located in the communal sitting room and quiet room of the home. We were told that the quiet room, the lounge, and residents bedrooms have had some new furnishings since the previous key inspection. Since the previous key unannounced inspection the home has moved the smoking sitting room to a covered area in the garden area of the home. An interior non smoking room is now accessible to people using the service. The manager, and AQAA information told us that residents made the decision to no longer smoke in the house. A resident spoke of being happy with the outside smoking area. Following the inspection, we were told by the manager that the windows of the lounge at the front of the house are in need of repair, with regard to ensuring that they can be opened. The manager told us that the windows had been risked assessed as safe. Following the inspection we were informed of the date (November 6th 2008) when these windows would be refurbished. The home has an enclosed garden, which was well maintained. We were shown by a resident, the garden summer house seating area, which we were told had recently been painted, by staff and a resident. A person using the service told us that the garden was regularly used in the good weather by residents. Since the previous inspection a ground floor bathroom facility has been refurbished, and a walk in shower installed. We were told by the manager that upstairs bathrooms are to be refurbished. This is positive, and should take place promptly as it was noticed that there were some minor maintenance issues including a missing slat in a bath panel, which should be attended to. It was evident from talking to staff, and to residents that the time for getting maintenance issues repaired, can be a lengthy process. The timescale for completing repairs following being notified by the home should be reviewed. AQAA information told us that the home has plans to provide new fridge/freezers for the kitchen. Two people using the service kindly showed me their bedrooms. These bedrooms were individually personalised, with items of the persons choice. Both residents spoke of being happy with their bedroom. The laundry facilities are located away from food storage, and food preparation areas. Disposable gloves were accessible to staff and to others. A resident spoke of being fully involved in the laundering of their own clothes. Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: The home has an infection control procedure, which AQAA documentation told us had recently been reviewed. Records, including the AQAA, confirmed that staff had received infection control training. Hand soap and paper hand towels were accessible. The home employs a domestic member of staff to carry out cleaning duties in the home. Care Homes for Adults (18-65 years) Page 25 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled, and in sufficient numbers to support the people using the service, and the smooth running of the service. People using the service are supported and protected by the care homes recruitment policy and procedure. Evidence: The staff rota was available for inspection. There are generally one to two staff plus the manager on duty during the day, and a sleep in member of staff at night. AQAA information told us that there is always a senior member of staff available for decision making and emergencies. Staff spoke of there being flexibility in regards to staff numbers on duty, which we were told depends on the needs of the people using the service. AQAA information told us that the home has a full staff team. It was evident that staffing levels reflect the needs of people using the service. Staff spoke of their role as key worker to residents. This includes supporting residents to lead a quality life as independently as they are able, and participating with residents Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: in the review of their personal plan of support. Staff spoke positively of the communication systems within the home. A comprehensive staff handover took place during the inspection. From talking to staff, observation and records it was evident that staff are competent, well skilled, and have a good understanding and knowledge of how to meet each persons needs. Staff spoke of the staff induction programme that they had received, and confirmed that this ensured that they felt knowledgeable and competent in carrying out their role and responsibilities. We were told by a staff member that this staff induction involves a period of shadowing experienced care staff when they first carry out their duties, as a new staff member. AQAA information told us that two new staff had recently completed induction training. We were told that there is a low turnover of staff. Records and staff confirmed that they have the opportunity to attend regular staff meetings. Staff training records were inspected. These included individual staff training and development records. Care staff confirmed that they had received varied, and appropriate staff training to ensure that they are competent to care and support residents. Recent staff training included safeguarding adults training, fire training, and health and safety training. Certificates of staff training were available for inspection. These confirmed that staff had received appropriate training in several other areas. This training included moving and handling, medication, 1st Aid, and food and hygiene training. Records, and AQAA told us that the staff team have a number of qualifications, including half the staff having achieved National Vocational Qualifications (NVQ) level 3 in health and social care. We were informed that the deputy manager is a registered social worker, and that the two new staff are planning to commence the NVQ 3 training course shortly. We were told that a staff member had completed an NVQ assessors training course. It is evident from records and staff that management prioritise training, and facilitate staff members to undertake external qualifications beyond basic requirements. The home has a staff recruitment and selection procedure. Three staff personnel records were inspected. These included required information, such as confirmation that an enhanced Criminal Records Bureau (CRB) check (a check to gain information as to whether a person has a criminal record) had been carried out. We were told that people using the service now participate in the staff recruitment Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: process, and that several residents had volunteered to be on an interview panel. We were informed that their feedback is significant in the recruitment and selection process of staff. This is positive. It is evident from talking to staff and from procedures in place, that the home has a highly developed recruitment procedure that has the needs of people who use the service at its core, and that the staff recruitment, with residents participation is seen as integral to the delivery of an excellent service. Records, and staff told us that staff receive regular 1-1 staff supervision, and appraisal, to ensure that staff are supported in their role, and have the opportunity to develop and achieve goals in regard to carrying out their duties in caring and supporting people using the service. Staff spoke of sharing skills and knowledge with colleagues, and had an awareness of their roles and responsibilities. People using the service told us that their needs are met with support from the staff team. It was evident that they know the staff team well, including knowing the names of staff, and confirmed that staff are approachable. Care Homes for Adults (18-65 years) Page 28 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems, which ensures that a quality service is provided to people using the service. So far as reasonably practicable the health, safety and welfare of people using the service is promoted and protected. Evidence: The manager has a Registered Managers Award, NVQ (National Vocational Qualification) level 4, an NVQ level 4 in care and social health, and an NVQ Assessors qualification. AQAA information told us that the registered manager has more than ten years experience in a management in a social care setting, and 19 years total experience in social care. He has a very much hands on approach, and spends significant time supporting residents to meet their individual needs. He told us that he generally works during weekdays but on occasions, does complete weekend shifts. It was evident that during the three years since he has managed 79 Harrow View he has Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: been pro active making a number of changes to improve the quality of the service for residents. Records and the manager confirmed that he ensures that he updates his knowledge and skills. It is evident that the service has a sustained track record of delivering good performance, and of managing improvement. Where areas for improvement emerge the service recognises, and manages them well. Talking to staff, and inspection of records confirmed that the home has systems in place to improve and monitor the quality of the service provided to people using the service. We were shown a quarterly quality assurance audit monitoring document. We were told that audits of the service are resident led, and include a number of objectives to improve and develop the service. The home completed the AQAA comprehensively. We were told that the home regularly obtains feedback about the service from residents. The home has a health and safety policy, and risk assessment. No health and safety issues were noted during the inspection. Records confirmed that required service checks of gas and electrical systems in the home are carried out and are up to date. Records and staff told us that fire safety systems are monitored closely. Regular fire drills, and fire training takes place. The home has a fire risk assessment,. There are displayed procedures in place with regard to action to be taken in the event of a fire. Accidents and incidents are recorded as required. The care home has an up to date employers liability insurance certificate, which is displayed. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 31 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 24 The upstairs bathrooms could be refurbished. To ensure that the bathroom environment and facilities are pleasant, suitable and well maintained. Maintenance issues within the care home could be resolved more promptly to ensure that these are carried out within reasonable timescales. Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 33 of 33 - 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!