Inspection on 13/11/06 for Becklow Road

This inspection was carried out on 13th November 2006.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Becklow Road 08/02/08

Becklow Road 24/05/06

Becklow Road 25/05/05

Becklow Road 01/07/04

Becklow Road 05/06/04

Becklow Road 07/01/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Becklow Road, 161/163 Becklow Road 161/163 Becklow Road Shepherds Bush London W12 9HH Lead Inspector Tony Lawrence Unannounced Inspection 13th November 2006 09:00 Becklow Road, 161/163 DS0000019147.V317045.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 Becklow Road, 161/163 DS0000019147.V317045.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. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Becklow Road, 161/163 Address Becklow Road 161/163 Becklow Road Shepherds Bush London W12 9HH 020 8932 3916 020 8743 2333 info@yarrowhousing.org.uk 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) Yarrow Housing Mr Michael Antonio Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2006 Brief Description of the Service: 161/163 Becklow Road is a home for 6 people with a learning disability aged 18 - 65. There are 5 people living at Becklow Rd at present, three men and two women. The home is operated by Yarrow Housing Limited, and is located in the Shepherds Bush area of London. The house is a detached, three storey modern building - the top floor providing an office, shower, toilet and sleep-in facilities for staff. The 1st floor has three bedrooms, lounge, kitchen and bathroom / toilet. The ground floor has three bedrooms, kitchen, lounge and two accessible bathroom / shower rooms. The lounge leads onto a large garden/patio area. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Monday 13th November 2006 from 09:00 – 12:30. The Inspector spent time talking with service users, staff and managers, checking care records and touring the building. The Inspector also reviewed the care of two people living in the home in more detail. The home provides good standards of accommodation, is well staffed to meet the care needs of service users and standards of record keeping are good. People living in the home are supported to take part is a varied programme of activities during the day, evenings and at weekends. The Inspector felt that managers and staff have worked well since the last inspection to improve care standards in the home. Nine requirements made at the last inspection have all been met. Relatives and health and social care professionals returned three confidential questionnaires and their comments are included in the report. The weekly fee for the service is £1,800. What the service does well: What has improved since the last inspection? What they could do better: The use of service users’ personal money to pay for meals, towels and bedding must be reviewed. Managers in the home must also make sure that medication records are accurate. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Becklow Road, 161/163 DS0000019147.V317045.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 Becklow Road, 161/163 DS0000019147.V317045.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 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear admission and referral criteria and potential service users are supported to make a positive choice to move into the home. EVIDENCE: Information provided by the Manager before this inspection and discussion with staff on the day confirmed that no new service users have moved into the home since the last inspection. There is currently one vacancy and staff are working with the multi agency Learning Disability Team to identify people whose care needs can be met in the home. Following a Requirement made at the last inspection, a Service User Guide has been introduced for each person living in the home. The Guide makes excellent use of photos and line drawings to make the information more accessible to service users. The Guide clearly details the services provided in the home, the fees that are charged and service users’ rights and responsibilities. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 9 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of people living in the home are well assessed and recorded. Individual service users benefit from a programme of appropriate activities in the home and the local community. EVIDENCE: During this visit the Inspector checked the Person Centred Plans (PCP) of two people living in the home. Since the last inspection, information on service users’ care needs has been reorganised and all relevant information is now kept in individual files. The two files checked during this visit were both well organised and up to date. Both files included the Service User Guide, PCP Planning Book and Action Plan review. The Action Plans included clear goals for individuals and details on how these would be met by staff in the home and others. Both files included a weekly programme of activities for the individual service users. Staff said that the programmes are flexible and can be adjusted to reflect service users’ choices and preferences each day. During this visit, four of the five service users took part in activities in the local community, supported by care staff. The Manager confirmed that, following a Requirement made at the last inspection, staff have reviewed the risk assessments for all people living in the Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 10 home. Both files checked during this visit included updated risk assessments covering challenging behaviours, travel by car and public transport and details of action needed to minimise the risk. One risk assessment in particular considered the likelihood and severity of each risk plus the benefits and possible cost of allowing the risk. The Inspector felt that this approach should be extended to risk assessments for other people living in the home. Although standards of care planning, care recording and risk management in the home are good, staff must make sure that they sign and date any records they complete. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 11 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to a range of appropriate activities, including an annual holiday. EVIDENCE: ‘The care the staff give goes above and beyond their duty. We have nothing but praise for them. I would not like my relative moved to any other house, as it is the best he has ever had. It is a happy home, which is the result of good senior managers passed down through the ranks’. Comment received from a relative. Each of the two service user files reviewed by the Inspector included a weekly programme of individual activities. During this inspection, staff supported four of the five service users to access activities in the local community. One person went to a pottery class with one member of staff; two service users went shopping, each with one member of staff and one service user went to Holland Park in his car, supported by two staff. The fifth person living in the home was unwell and stayed in bed during this inspection. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 12 Details of service users’ relatives, friends and other significant people are recorded in the care plan file and staff said that they make sure individuals stay in contact with these people. One person goes home every weekend to stay with their parents and staff provide support to enable this. Managers and staff confirmed that all five people living in the home had a week’s holiday in Ireland or Wales, supported by staff. When the Inspector arrived at the home, four service users had finished their breakfasts. While waiting for staff to support them with community activities, service users asked for and were given drinks and snacks. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 13 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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal care needs are well recorded and their physical and emotional health needs are met in the home. EVIDENCE: Both service user care plan files checked by the Inspector included a healthcare needs checklist that details appointments with the person’s GP, dentist, optician and clinicians from the Learning Disability Team. The checklists seen were well completed and are evidence that staff respond to health care issues appropriately. The Manager confirmed that, following a Requirement made at the last inspection, the issue of male staff supporting female service user with intimate personal care was discussed at a staff meeting. Staff reported that they are now encouraged to be more flexible when supporting service users, to make sure that same gender care is usually given. Following a second Requirement, a service user was referred to their GP and has since attended hospital for treatment. The Manager confirmed that medical staff are confident that the treatment has been successful. A followup appointment has been made with the hospital for January 2007. Both files also included detailed guidance for care staff on the way in which the service users communicate. Detailed care guidelines also highlight known Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 14 triggers that may cause distress or anxiety and ways that these can be avoided. Two health and social care professionals returned confidential questionnaires sent out as part of this inspection. They commented that staff communicate clearly and work well in partnership. Both said that staff demonstrate a clear understanding of the care needs of service users and follow specialist advice given in the service user’s care plan. Both said that they are satisfied with the overall care provided to service users and neither person had ever received any complaints about the home. As part of this visit the Inspector checked the medication records for two people living on the first floor. The records were well maintained but there is a need for staff to make sure that records are completed accurately. In one case, the Medication Administration Record sheet included two gaps where staff had failed to sign the record. This was discussed with one of the home’s deputy managers who explained that the sheet should have showed the medication was to be given ‘as required’. Managers in the home must make sure that medication records are accurate. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Managers and staff in the home respond well to complaints and service users are cared for safely. EVIDENCE: The Manager confirmed that there have been no adult protections incidents or investigations since the last inspection. One formal complaint about noise from the home has been received from a neighbour. This was well recorded and appropriate action was taken to resolve the neighbour’s complaint. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 16 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, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good standard of private and communal accommodation. More work is needed to make bathrooms more comfortable and homely for service users. EVIDENCE: During this visit the Inspector saw all communal parts of the home and three service users’ bedrooms. The home provides good standards of accommodation. All parts of the home were clean, tidy, comfortably furnished and well decorated. Staff have completed some good work with one service user to personalise their bedroom and this has greatly improved the quality of life for this person. Two other bedrooms were well personalised and comfortable. Communal areas are comfortable and well equipped but a recommendation made at the last inspection to improve standards in the home’s bathrooms has not been met. The bathrooms and very bare and unwelcoming and more should be done to make these areas more attractive for service users. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 17 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): 32, 34 and 35. 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 staffed by a team of experienced and qualified managers and care staff. EVIDENCE: Following a Requirement made at the last inspection, one of the home’s Deputy Managers confirmed that staffing levels at weekends have been increased. The Inspector checked the staff rota for November 2006 and this showed that there are now three staff on each shift at weekends. During this visit the home’s Manager and two deputy managers were working day shifts. Three care staff were also working day shifts and two other staff were working late shifts to 9:00 pm. At night there is one waking night staff and a second person on call in the home. The Manager confirmed that all staff have obtained an Enhanced Disclosure from the Criminal Records Bureau but a record of these must be kept in the home for inspection. Since the last inspection, the home has passed the target for 50 of the staff completing their NVQ training. Staff on duty during this visit demonstrated a good understanding of the care needs of individuals and all worked well together as a team to make sure that care needs were met. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 18 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, 40, 41, 42 and 43. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has an experienced management team and service users views are considered as part of any review of the services provided. EVIDENCE: The home’s Manager is registered with the Commission and two experienced Deputy Managers support him. The two care plan files reviewed by the Inspector during this visit each contained a quality assurance questionnaire completed during 2006. People independent of the home supported the two service users to record their views on the services and support they receive. One questionnaire was completed with support from a former member of staff and this included some excellent comments that reflected the service user’s views. The second questionnaire was not completed as well and the Inspector felt that other people should have been involved in the process, including the service user’s parents. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 19 Following a Requirement made at the last inspection, the frequency of monthly monitoring visits by representatives of the service provider has increased. Although some of the reports written following these visits are brief, all refer to the experiences of people living in the home and the implementation of CSCI Requirements is also monitored. Yarrow Housing’s policies and procedures are available in the office for staff reference. There is a good record of regular staff and service user meetings. A selection of health and safety records was checked and these were well completed. One issue was discussed with the home’s Manager during this visit. When checking service users’ finance records, the Inspector noted that one person had spent £20 of their own money to buy West Indian food while on holiday. Other service users are spending an average of £25 a month buying lunches. In discussion, the Manager confirmed that service users also pay for towels and mattresses for their beds, when these need replacing. The use of service users’ personal money for these purposes must be stopped, as these items must be provided by the home. If a service user chooses to have a meal out, this should be allowed, but it should not become a regular practice that the service user funds this themselves. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 20 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 3 3 X 4 3 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 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 2 3 3 3 Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard YA20 YA34 Regulation 13 19 20 Requirement Managers in the home must make sure that medication records are accurate. A record of staff CRB Disclosures must be kept in the home for inspection. The use of service users’ personal money to pay for food, towels and bedding must be stopped. Timescale for action 15/12/06 15/12/06 15/12/06 YA40 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. 2. Refer to Standard YA9 YA9 Good Practice Recommendations The practice of assessing the likelihood and severity of a risk, plus the benefits and cost of allowing a risk should be extended to all people living in the home. Staff should make sure that they sign and date all care records kept in the home. Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Becklow Road, 161/163 DS0000019147.V317045.R01.S.doc Version 5.2 Page 23 - 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!