Inspection on 10/10/05 for 8 Courtenay Avenue

This inspection was carried out on 10th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8 Courtenay Avenue 31/10/06

8 Courtenay Avenue 29/11/05

8 Courtenay Avenue 16/11/04

8 Courtenay Avenue 22/07/04

8 Courtenay Avenue 25/02/04

Similar services:

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

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

CARE HOME ADULTS 18-65 8 Courtenay Avenue T/A Idelo Limited 8 Courtenay Avenue Harrow Middlesex HA3 5JJ Lead Inspector Ms Virginia Allen Unannounced Inspection 10th October 2005 09:00 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 8 Courtenay Avenue Address T/A Idelo Limited 8 Courtenay Avenue Harrow Middlesex HA3 5JJ 020 8428 2338 020 8420 1861 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) T/A Idelo Limited Ms Minna Roach Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2004 Brief Description of the Service: 8 Courtney Ave is a registered care home providing personal care and accommodation for a maximum of 3 adults aged 18-65 who have learning disabilities. There were two service users living in the care home at the time of the unannounced inspection. The registered providers are Mr Winston Mayers and Ms Diane Eastman trading as Idelo Ltd. The registered manager is Ms Minna Roach. The home is located on a main road that leads into central Harrow. It is close to a bus stop that allows service users access to Harrow’s shops, pubs and other community and leisure amenities. The care home is a two storey dwelling with all bedrooms located on the first floor. The building is well set back from the road. All of the bedrooms are single and none have en-suite facilities. The home has gardens to the rear that are well maintained and accessible through the rear conservatory and side extension. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on a sunny Monday and commenced around 7.30 am. During the inspection the inspector spoke with the care staff, the service users and the registered proprietor. The inspector toured the building, looked at records and observed care practices. The home has a registered manager who was on leave at the time of the inspection. The proprietor answered questions that could not be answered by the care staff. The home was clean, bright and airy and both of the service users expressed their satisfaction with the home. The inspector would like to thank the proprietor and the two service users for assisting with the inspection. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be devised for each service user, generated from their assessments and covering all aspects of personal and social support. It also needs to cover healthcare needs such as skin integrity, washing and dressing, oral hygiene, mobility, psychological health etc. The plan sets out how current and anticipated specialist requirements will be met. The plan must be drawn up with the assistance of the service user together with family, friends or advocate as necessary. Service user likes and dislikes need to be added. The plan is reviewed monthly with the service user involvement and the agreed changes recorded. Service user involvement must be recorded. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 6 The wishes of the service user and their family in relation to illness or death should be recorded in their care plan along with the spiritual needs of the service user. 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. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Prospective service users have the information they need to make an informed choice about where they live. Prospective users individual aspirations and needs are assessed and they know that the home they choose will meet those needs. Prospective service users have an opportunity to visit and test-drive the home. Each service user has an individual written contract and/or statement of purpose. EVIDENCE: The inspector discussed the service user admission procedures with the proprietor. Prior to admission the service user and their family receive a package of information relating to the home and the care provided. The service user and the family are given the opportunity to visit the home. The service user is encouraged to stay overnight and to experience the home environment before making their decision about accepting placement. Since the last inspection there has been one admission. The inspector viewed the files of both of the current service users. Prior to admission, a full assessment was made of all of the service users needs by their social worker. The home then assessed the needs of the service user. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 9 The service user was asked to contribute to this assessment by talking about their likes and dislikes and goals for the future. Records demonstrated a comprehensive initial assessment, which assisted the home in planning the care of the service user. The inspector discussed admission with the service users. Both of the current service users agreed that they had made their own decision about living at the home and were comfortable with the outcome. They were happy with the care they received from staff and could not suggest anything that they wished to change. Special services are available for the individual needs of the service user and records showed that these services were being accessed appropriately. Both of the service users had a written contract with the home. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Care plans reflecting the assessed and changing needs and the personal goals of the service user need to be devised. Service users make decisions about their lives with assistance and they participate in all aspects of life at home. Service users are supported to take risks as part of an independent lifestyle. EVIDENCE: Discussion with the service user showed that they were familiar with their daily and weekly routine and were involved in the planning of their care. However, documentation in a detailed action plan and written evidence of service user involvement in the care planning and review process still needs to be addressed. Individual risk assessments are documented and were viewed by the inspector in the service user files. The inspector talked individually with each of the service users about their daily routines and their likes and dislikes. They both enjoyed day care and 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 11 were proud of the work they produced whether it was solving puzzles or art work. One of the service users attended college to learn computing. The service users assured the inspector that they were involved in making their own decisions. The inspector observed the service users making their own breakfast and preparing a packed lunch to take with them to day care. They were familiar with the kitchen and only required minimal prompting to complete the domestic tasks involved. They were aware of the colour coded chopping board system and the differences in the waste bins. The service users reported that they also helped to maintain the cleanliness of the home. Thus, they demonstrated their familiarity and involvement with the daily running of the home. The daily food menu was on display in the kitchen. It reflected the individual food choices of each of the service users. One service user is a vegetarian. Service users had been on a holiday to Spain. The service users were keen to show the inspector the photos of their trip and to explain who were in the photos. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Service users are able to take part in peer and culturally appropriate activities and are part of the local community. Service users engage in appropriate leisure activities and have appropriate relationships. Service users rights are respected. They have a healthy and balanced diet. EVIDENCE: Service users spoke with the inspector about their day care activities. One service user enjoyed solving puzzles while the other service user enjoyed drawing and colouring. They both told the inspector that they liked going to day care. One service user told the inspector that she also goes to college once a week to learn computing. This was a source of pride to her. She also said that she liked to play games on the computer. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 13 Both of the service users go home on the weekends with their families. The family take them to church. One of the service users took the inspector to their bedroom to show her their family photos. She wanted the inspector to know who everyone in her family was. When the service users are not occupied with their routine daily activities, they enjoy watching TV, listening to music, reading and shopping. Both service users had a lockable bedroom door but preferred the care staff to hold their key. The inspector spent several hours observing the service users going about their morning routine and interacting with the care staff at the home. They were familiar and comfortable. Care staff prepare evening meals with the assistance of the service user. The weekly menu is kept on display in the kitchen and the inspector noted that the food was varied and nutritious. One service user enjoys meals containing meat while the other service user has vegetarian meals. The food cupboards in the kitchen and storeroom were viewed by the inspector and noted to contain a large range of food. The fridge and freezer were full and all food that was opened had been dated and was still fresh. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Service users receive personal support as well as emotional and physical health needs met. The service user is protected by the home’s policies and procedures dealing with medicines. The death wishes of the services user needs to be documented in the care plan. EVIDENCE: The home accesses when necessary, specialist support services such as psychological therapy, community nursing or medical support. Discussion with the proprietor assured the inspector that individual needs are being met and outcomes from specialist services have been successful. All medications are stored in a locked cupboard. The inspector viewed the two service users receiving their morning medication. They were familiar with the routine and endeavoured to follow medical recommendations in relation to medication taking. The inspector viewed the medication administration record book and it was noted that all medications had been signed for. Staff has undergone medication training. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 15 Medications are administered from a blister pack supplied by the pharmacy. The proprietor and the staff on duty informed the inspector of the spiritual needs of both of the service users. However, this needs to be documented in their care plan. The proprietor informed the inspector that in the case of a death, the family would be informed and would make decisions about funeral arrangements. This needs to be discussed with the family and recorded in the care plan. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users feel their views are listened to and acted on and that they are protected from abuse, neglect and self-harm. EVIDENCE: The inspector talked with the two service users about whether or not the home was meeting their needs. Both service users felt that they could express their opinions and that they were listened to. However, better documentation of the service users view with their likes and dislikes would be good practice. Both service users are happy to live at the home. The proprietor confirmed that all of the care staff have undergone Protection of Vulnerable Adult training and the policy is recorded and contained in the policy and procedure manual. The home staff are sensitive to the psychological needs of the service user and individual needs are addressed as they arise. Specialist services are accessed as necessary and the proprietor confirmed that this policy has been successful. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 Service users live in a homely, comfortable and safe environment. Their bedrooms suit they needs and promote independence. compliments and supplements the service users rooms. Bathrooms and toilets are lockable. The home is clean and hygienic. EVIDENCE: The service users took the inspector on a tour of the premises. This included the communal areas, kitchen, bathrooms and their bedrooms. The home was perfectly clean and free from odour but was also homely. The communal areas were comfortable and well decorated. The furnishings were domestic in nature. The service users were observed moving freely about the house as if it were home. One service user had her bedroom decorated with personal items and family portraits and pictures. The service user who has most recently joined the house is still to decorate her bedroom. The proprietor is to pursue this. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 18 Shared space Heaters in the house were covered for safety. there was a banister for support. The stairs were carpeted and The service user toilet and bathroom area is upstairs next to the bedrooms. The inspector noted that it was clean and had a lock on the door for privacy. The laundry area was clean and tidy and contained areas to place linen. There was a washing machine and dryer and the area can be accessed without taking dirty linen through eating areas. The daily handover sheet for support workers recorded the fridge freezer temperatures, the fridge temperature, temperature of the water up stairs and down stairs, cleaning checks and daily finance record of both service users. The house was well maintained by the proprietor. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Service users benefit from the clarity of staff roles and they are supported by competent and qualified staff who form an effective team. Service users are protected and supported by the home’s recruitment policy and their needs are met appropriately. Service users benefit from well supervised staff. EVIDENCE: The inspector viewed the file of a care staff member. Staff are not employed until they have a CRB check and supply two recent references. Each staff file contains the documentation of an agreed career and development plan devised between the staff member and the manager. The inspector was shown the documentation of roles and responsibilities procedure for care staff. All staff are given this documentation and are aware of what is required of them. The two proprietors and the manager of the home have completed NVQ 4. Two support workers are completing NVQ 3 and two support workers are about to commence NVQ 2. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 20 Interaction and communication between the duty support worker and the service users during the inspection showed there was good understanding of service user needs and a good level of respect. The inspector viewed the training programme file. Staff training included health and safety awareness, manual handling, fire awareness, infection control and first aid. Staff members receive formal supervision 6 monthly and staff appraisal annually. Grievances and disciplinary procedures are documented in the policy and procedure manual. The proprietor informed the inspector that staff was stable and there was negligible sick leave. Hence, there was very little need for agency staff. Staff meet monthly and the inspector viewed documentation of each meeting. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,40,41,42,43 Service users benefit from a well run home and the ethos of the management. Service users rights and best interests are safeguarded by the home’s policies and procedures. The health, safety and welfare of service users are promoted and protected. The Service users benefit from management that is competent and accountable. EVIDENCE: The home has a well-defined statement of purpose. This is documented in the policy and procedure manual. Staff are made familiar with this information and are required to adhere to the home’s aim. The home is person centred and is run in the best interest of the service user. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 22 The service development plan for 2005 with aims and objectives of the home was displayed in the front entrance. The fire action plan was also displayed in the front hall. The proprietor assured the inspector that there is an open policy. The service user has the right to view their own records. All personal records are kept in a lockable office. All policy and procedures pertaining to the service user, staff or the running of the home are documented. Staff are required to familiarize themselves with these procedures. It is recommended that staff sign to show that they have read each of these procedures. This is good practice. The inspector viewed current maintenance records. Gas, including the boiler, was inspected in 2005 and is renewed yearly. Certificate of compliance for portable and electrical appliances was inspected on 1st April, 2005. The inspector viewed the cossh assessment, risk and precautions for hazardous material safety data sheets. Public liability insurance was renewed on 11th May, 2005. 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 8 Courtenay Avenue Score 3 3 3 1 Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 3 3 DS0000035899.V258112.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 (1) Requirement Care plans need to be constructed that give the detailed information of what care is being provided and how that care is achieved Care plans must show evidence of service user input. They must detail the likes and dislikes of the service user on each topic. Care plans and the monthly review must show evidence of service user agreement. This could be a signature of the service user or their representative. Care plans must have the documentation concerning the death and dying wishes for each service user. Timescale for action 20/12/05 2 YA6 15 20/12/05 3 YA6 15 20/12/05 4 YA21 12 (a) 20/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 25 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 8 Courtenay Avenue DS0000035899.V258112.R01.S.doc Version 5.0 Page 27 - 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!