Inspection on 25/06/07 for Great Western Road, Flat 3, 22-24

This inspection was carried out on 25th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Great Western Road, Flat 3, 22-24 22/06/09

Great Western Road, Flat 3, 22-24 11/08/08

Great Western Road, Flat 3, 22-24 02/05/06

Great Western Road, Flat 3, 22-24 06/12/05

Great Western Road, Flat 3, 22-24 27/06/05

Great Western Road, Flat 3, 22-24 19/11/04

Great Western Road, Flat 3, 22-24 26/04/04

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Ashlong House

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Edenvale

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Chatsworth Care - Dawson House

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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 Great Western Road, Flat 3, 22-24 22-24 Great Western Road London W9 3NN Lead Inspector Tony Lawrence Key Unannounced Inspection 25th June 2007 09:10 Great Western Road, Flat 3, 22-24 DS0000010877.V344768.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 Great Western Road, Flat 3, 22-24 DS0000010877.V344768.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. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Great Western Road, Flat 3, 22-24 Address 22-24 Great Western Road London W9 3NN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 7289 5041 020 8964 5507 The Westminster Society for People with Learning Disabilities Christine Quantock Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2007 Brief Description of the Service: Flat 3 is a purpose built, wheelchair accessible, first floor flat providing accommodation and care for men and women with a learning disability. There are currently 4 women and 2 men living in the home and there are no vacancies. The property is owned and maintained by Paddington Church Housing Association, and the care is provided by the Westminster Society for People with Learning Disability, a voluntary organisation. The home is located in a residential area of Westbourne Park, close to shops and transport links. The home is part of a small residential block that includes a second registered care home and six flats for people with a learning disability who are living independently. Each person living in the home has his or her own bedroom. Communal areas, bathrooms and toilets are shared. The current weekly fee for the home varies from £1,101 - £1,660, with no additional charges. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.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 25th June 2007, from 09:10 – 16:30. Tony Lawrence, CSCI Regulation Inspector, spent time in the home, talking with residents, staff and managers. He also watched staff supporting residents, saw all communal parts of the home and four people’s bedrooms and checked selected care records. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 6 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 Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 7 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, 4 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 established referral and admission procedures that involves people who are moving into the home. EVIDENCE: During this visit the Inspector checked the care plan files of two residents, including one person who had moved into the home since the last key inspection. Although this person moved from another registered care home managed by the Society, managers and staff made sure that a detailed care needs assessment was completed and reports were provided by other health and social care professionals. A three-week transition plan was developed that included regular visits to Flat 3 to meet staff and other residents, meals in the home and overnight stays. The file also included clear evidence that the resident concerned had been involved in planning their move. The two care plan files checked by the Inspector did not include a contract or statement of terms and conditions and the recently appointed manager was not able to locate these during the site visit. The Society must make sure that each person living in the home has a contract and this must be included as part of their personal file kept in the home. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 8 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. Standards of care planning have improved since the last inspection. People living in the home are involved in planning their care. EVIDENCE: Following the last key inspection in November 2006, a statutory Enforcement Notice was issued, requiring the Society to improve the standard of care planning and care plan reviews in the home. At a follow-up inspection in January 2007, the Inspector noted that care plans had been reviewed and staff had completed some good work to involve one resident in planning their own care and support. The Inspector concluded that the requirements of the Enforcement Notice were met at the inspection in January 2007. During this visit the Inspector checked the care plan files for two people living in the home. Both files were well organised, although a lot of the older information could be removed to make the current information easier to find. Managers told the Inspector that the Society is introducing a system of person centred planning for all residents. Care staff complete ‘All About Me’ forms with residents to gather basic information that is used to develop a care plan. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 9 This is a significant piece of work and the Inspector felt that staff were managing well to complete the documentation and involve residents. One file checked by the Inspector included clear guidance for staff on supporting the resident with their personal care needs, a current communication plan and a service user plan that was reviewed in May 2007. A Placement Monitoring Officer from the local authority reviewed the person’s placement in the home in January 2007. The second file also included ‘All About Me’ forms and a service user plan dated April 2007. The plan was person-centred and included very good guidance for staff supporting the resident. Both files checked by the Inspector included risk assessments that had been reviewed in May 2007. The assessments covered a range of potential risks, including access to the local community, bathing, epilepsy, falls, personal care and fire safety. All assessments were well completed and included clear guidance for staff on minimising risks. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 10 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, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to take part in a range of appropriate activities and maintain contact with significant people. EVIDENCE: During this visit the Inspector talked to people living in the home and checked the daily care notes completed by care staff for two people and the book that is used to record each person’s daily activities. Flat 3 provides care and support for a group of mostly older people with a learning disability, with residents’ ages ranging from 42 – 81. People’s interests were well recorded as part of their care plan and the daily notes and activity book showed that each person takes part in age-appropriate activities each day. These included walks in the local area, visits to parks, shops, cafes and pubs, church services, dance classes and visits to the home by a massage therapist. One of the two care plans checked by the Inspector recorded the resident’s religion. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 11 The names and contact details of residents’ relatives, friends and other significant people were recorded as part of their care plans. Daily care notes showed that people are supported by staff to maintain contact with people outside the home by visits, phone calls etc. The weekly menu was displayed on the kitchen notice board. The menu showed a variety of nutritious meals are provided. During this visit the Inspector saw one member of staff supporting a resident to make soup for their lunch. The kitchen / dining room is bright and spacious. Residents told the Inspector that they could eat meals in the dining room, lounge or their bedrooms. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 12 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. The personal and health care needs of people living in the home are well recorded in their care plans. EVIDENCE: Both of the care plan files checked by the Inspector during this visit included a Health Action Plan (HAP) that had been partly completed. Managers told the Inspector that the HAP’s are being introduced for each resident and appointments have been made with individual’s GP’s to complete the plans. Both files included clear evidence of some good joint work with health care professionals, including physiotherapists, occupational therapists, hearing aid clinic and local mental health services. Following Requirements made at the last key inspection in November 2006, the management of residents’ prescribed medication has improved. People’s photos are now included on medication record sheets, allergies are recorded where known and the administration of medication was well recorded for all six people living in the home. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. There is a need to improve staff understanding of local safeguarding adults policies and procedures. EVIDENCE: The home has a clear complaints procedure that is produced in a format that is accessible to some people living in the home. The Inspector saw a copy of the procedure on each of the two residents’ care plan files checked during this visit. The Inspector checked the home’s complaints book and there is a need to improve the recording of complaints received. The record must include details of actions taken in response to complaints, the outcomes for people making complaints and whether or not they are happy with the outcomes. During this visit the Inspector checked the management of two people’s finances. One person’s finances were well recorded and receipts were available for each transaction. The recording of the second person’s finances must be improved. This person did not have a bank account and managers and staff were unclear whether the person was subject to receivership or appointeeship; they had no knowledge of the amount of money the person had or whether their savings were receiving interest. Staff had also introduced a system of loans from the home’s petty cash and this practice must be stopped. The Inspector also checked the home’s incident book and this showed that staff are unclear about the local safeguarding adults procedures and how significant incidents must be reported to the local authority and the Commission. Managers and staff must make sure that they understand and follow the local safeguarding adults procedures. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 14 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, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good standard of accommodation that is accessible to people with mobility problems. EVIDENCE: Flat 3 is a purpose built, wheelchair accessible, first floor flat, owned and maintained by Paddington Church Housing Association. The home is located in a residential area of Westbourne Park, close to shops and transport links. Each person living in the home has his or her own bedroom. Communal areas, bathrooms and toilets are shared. During this visit the Inspector saw all communal parts of the home and four people’s bedrooms. All parts of the home were comfortably furnished and well decorated. Bedrooms are comfortable and reflect individual’s personalities. There is a sufficient number of wheelchair accessible toilets and assisted bath / shower rooms and managers told the Inspector that fixed hoists are due to be installed. All parts of the home were clean and hygienic. Storage should be provided in bathrooms and toilets for gloves pads etc. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 15 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, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff work well together to support residents, but there is a need to make sure that staff are appropriately trained and qualified. EVIDENCE: Information provided by the Manager before this inspection is evidence that the home has 7 permanent members of staff, including the newly-appointed Manager and Deputy Manager. There has been a high turnover of staff since the last key inspection and most of the care staff have worked in the home for less than a year. Two staff have completed their National Vocational Qualification (NVQ) Level 2 training. The Manager is completing his NVQ Level 4 training and the Deputy Manager and one support worker are completing their NVQ Level 2. While the standard of 50 NVQ qualified staff has not yet been achieved, the Inspector is satisfied that the Society has arrangements in place to meet the standard in the near future. When the Inspector arrived for this unannounced inspection, the Manager, Deputy Manager and two support workers were on duty. The Society’s Service Manager also came to the home to help with the inspection. The Inspector felt that this was an appropriate number of staff to support people living in the Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 16 home. The staff team worked well together to meet individual’s care needs and responded to requests for support promptly. Information provided by the Manager before this inspection is evidence that all required checks are carried out on new staff as part of the Society’s recruitment policy and procedures. The Manager also confirmed that all staff have a Criminal Records Bureau (CRB) Enhanced Disclosure before they start work in the home. The Society must make sure that a copy of CRB Disclosure details is kept in the home for inspection. The last inspection report included a Requirement that the Society must make sure that staff complete essential skills training and a record of training should be kept in the home. During this visit the Inspector checked the home’s training records. While the new manager has completed some work to review staff training and improve standards of record keeping, it was clear during this visit that there are still significant gaps in the training that staff have completed. The Society must make sure that all staff working in the home complete essential training and accurate records must be kept. The Manager confirmed that all staff working in the home receive regular formal supervision with the Manager or Deputy Manager. A written record is kept of each supervision session. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 17 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, 41 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Society must make sure that the home’s Manager is registered with the Commission. EVIDENCE: Following the departure of the previous Manager, the home’s Deputy was appointed as the new manager in April 2007. The Manager confirmed that he has not yet applied for registration with the Commission. The home has now been without a registered Manager for more than six months and the appointed Manager must now apply to the Commission without further delay. As part of the Society’s quality assurance systems, an external auditor has completed a review of the services provided in the home. The review involved people living in the home and other significant people and the Commission was provided with a copy of the final report. During this visit the Inspector reviewed a selection of records kept in the home, including care plans, daily care notes, medication, finance and training Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 18 records. Most records are well maintained and managers are aware of areas where some improvement is needed, in particular the recording of complaints and safeguarding adults issues. The Inspector noted no health and safety issues during this visit. Staff in the home keep the required health and safety records and the Inspector saw that these are up to date. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 19 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 2 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X 3 3 X Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 20 Yes 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 YA22 Regulation 22 Requirement The recording of complaints received must be improved to include action taken and the outcomes for people making complaints. The management of one person’s finances must be reviewed. Managers and staff must make sure that they understand and follow the local authority’s safeguarding adults policy and procedures. The Society must make sure that a copy of CRB Disclosure details is kept in the home for inspection. Training records must be improved and kept up to date to reflect the training undertaken. Repeat Requirement. Original timescale of 01/03/07 not met. The home’s new Manager must apply to the Commission for registration. Repeat Requirement. Original timescale of 01/02/07 not met. Timescale for action 31/08/07 2. 3. YA23 YA23 13 13 31/08/07 31/08/07 4. YA34 19 31/08/07 5. YA35 17 31/08/07 6. YA37 9 31/08/07 Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA27 Good Practice Recommendations Storage should be provided in bathrooms and toilets for gloves pads etc. Great Western Road, Flat 3, 22-24 DS0000010877.V344768.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West London 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 Great Western Road, Flat 3, 22-24 DS0000010877.V344768.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. 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