Inspection on 29/05/07 for Great Western Road, Flat 4, 22-24

This inspection was carried out on 29th May 2007.

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

Other inspections for this house

Great Western Road, Flat 4, 22-24 06/09/06

Great Western Road, Flat 4, 22-24 17/01/06

Great Western Road, Flat 4, 22-24 12/07/05

Great Western Road, Flat 4, 22-24 23/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 Great Western Road, Flat 4, 22-24 22-24 Great Western Road London W9 3NN Lead Inspector Tony Lawrence Unannounced Inspection 29th May 2007 09:00 Great Western Road, Flat 4, 22-24 DS0000010878.V336291.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 4, 22-24 DS0000010878.V336291.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 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Great Western Road, Flat 4, 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 4752 020 8964 5507 The Westminster Society for People with Learning Disabilities Miss Michelle Hart Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2006 Brief Description of the Service: Flat 4 is a purpose built, wheelchair accessible, second floor flat that is registered to provide care for 6 people with learning disabilities. At the time of this visit, 4 women and 2 men were living in the home and there were no vacancies. The property is owned by Paddington Churches Housing Association and the care is provided by the Westminster Society for People with a Learning Disability, a voluntary organisation. The home is located in a residential area of Westbourne Grove, 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 their own bedroom. Communal areas, bathrooms and toilets are shared. The current fee for the service is £1,158 per week with no additional charges. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 29th May 2007 from 09:00 – 15:15. Tony Lawrence, Regulation Inspector, carried out the inspection. He spoke with people living in the home, staff on duty and the Manager, saw all shared parts of the home and checked care records. The home is well staffed and people living there are well cared for. Eight Requirements made at the last inspection have all been met. Six Requirements and five Recommendations made by a CSCI Pharmacy Inspector following a visit in January 2007 have also been met. The weekly fee for a place in the home is £1,158. 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 4, 22-24 DS0000010878.V336291.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 4, 22-24 DS0000010878.V336291.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): 1, 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose clearly sets out the objectives and philosophy of the service, but needs to be updated. EVIDENCE: During this visit the Inspector checked the home’s Statement of Purpose and talked to staff about how people move into the home. Five of the current group of residents have lived together since the home opened in 1995 and the sixth person moved into the home in 2005. Staff told the Inspector that the person who moved in most recently visited the home several times for meals and stayed overnight before making the decision to move. The Manager told the Inspector that the home has clear referral and admission procedures and these would be followed when a vacancy is available in the home. These procedures are included in the home’s Statement of Purpose. The Statement is detailed and covers all of the services provided in the home. The Statement has been produced using pictures and photographs and the format is accessible to some residents. There is a need to review the Statement to include updated information about current staffing arrangements in the home and the Westminster Society. The Statement should also include updated contact details for the Commission. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.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. The home involves people in planning the care they receive, but there is a need to review risk assessments regularly. EVIDENCE: During this visit the Inspector spoke with three people living in the home and checked the care plans and individual risk taking agreements for two of these people. The home currently uses a system of Support Profiles. These detail the person’s health and personal care needs and how these will be met, in the home and elsewhere. Each of the two Support Profiles checked during this visit had been updated in January 2007. The Profiles were very detailed and covered all aspects of the person’s health and personal care needs. Some good work had been completed to develop a Person Centred Plan for one person and the Inspector felt that there was clear evidence of their involvement in writing the plan. The Manager confirmed that this system of care planning would now be extended to the other five people living in the home. The risk taking plan for one person was reviewed in January 2007. The inspector felt that the plan clearly highlighted any potential risks for the Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 9 resident, together with strategies for making sure that risks are minimised. The second person’s risk taking policy had not been reviewed since January 2006, although staff and managers told the Inspector that this person’s needs had changed since then. Managers and staff must make sure that risk taking policies are reviewed regularly and especially when a person’s support needs change. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.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, 13,15, 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 who live in the home are involved in meaningful daytime activities of their choice. The menu is varied and includes healthy options. EVIDENCE: When the Inspector arrived at 09:00, three people living in the home had already left for their day services. During the day, staff supported all six people living in the home to take part in activities. Activities were already planned as part of a regular individual programme, or chosen spontaneously by each person with advice and support from staff. During this visit the Inspector checked the daily log books for two people living in the home. The logs books are evidence that staff support each person to take part in meaningful activities each day, including evenings and weekends. One person’s log book showed regular day trips with their day service and frequent walks and bus rides supported by staff from the home. The second person’s log book showed that they spend more time in their room, but staff also make sure that trips to local cafes and days out are also arranged. People’s bedrooms seen by the Inspector were comfortably furnished and well equipped to enable individuals to take part in activities in their rooms. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 11 The two care plans checked by the Inspector during this visit included details of people’s relatives, friends and other significant people. The Inspector felt that the Person Centred Plan (PCP) that has been developed for one person was especially good at recording the names and contact details of people important to the service user. Information about food provided in the home was supplied by the Team Manager before this inspection. Menus show that a variety of nutritious food is provided and choices are always available. Staff who spoke with the Inspector said that they are always able to offer individuals meals of their choice and there was no need to stick to a regular planned weekly menu. The kitchen / dining room is large and provides a comfortable space for meals, parties etc. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.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. Each person’s healthcare needs are recorded as part of their care plan. Following Requirements made by a CSCI Pharmacy Inspector, the management of medication has improved. EVIDENCE: The Manager and staff told the Inspector that the Society has a policy on same gender personal care for people living in the home. Two care plans seen by the Inspector clearly recorded each person’s preferences as to how they are supported with their personal care. During this visit the Inspector checked the care plan files for two people living in the home. Both files included a Health Action Plan, one completed in April 2006 and the second in April 2007. The Plans included sufficient detail about the person’s health care needs and how clinicians and staff in the home would meet these. Both Plans were produced in an accessible format, making good use of Plain English and line drawings to make the information easier for people to understand. Two people living in the home are registered blind. The manager confirmed that a local authority Rehabilitation Worker is due to visit the home to assess one person and advise on equipment and adaptations that may help them Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 13 manage their disability. It is a recommendation of this report that the second person is also referred to the Rehabilitation Worker for assessment and advice. Following concerns about the management of prescribed medication in the home at the last key inspection, a CSCI Pharmacy Inspector visited the home in January 2007 to assess the home’s medication procedures. The Pharmacy Inspector made six requirements following her visit and the Inspector checked these during this visit. All six Requirements have been met and standards of medication management are now good. The home uses the Boots Monitored Dosage System for all prescribed medication and secure storage is provided. The Inspector checked the Medication Administration Record sheets for all six people living in the home. The records were well completed and staff consistently make very good use of codes to indicate when medication is not taken as prescribed. Staff are also recording the opening and disposal dates on bottles of eye drops. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 14 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. The home has a clear complaints procedure that is accessible to people living in the home. Staff support people living in the home to make complaints appropriately. EVIDENCE: The Manager confirmed that there have been ten formal complaints since the last key inspection. The Inspector checked the home’s complaints record and all complaints are well recorded. The record includes details of actions taken by staff in response to complaints and the outcome in each case. The Society’s complaints procedure is clearly written and makes good use of photographs to make the information more accessible to people living in the home. Information provided by the Manager before this inspection is evidence that there have been no adult protection investigations involving people living in the home since the last key inspection. Staff who spoke with the Inspector during this visit were clears about the local adult protection procedures and action they should take if they have concerns about residents. During this visit, the Inspector checked the finance records for two people living in the home. Both records were well maintained by staff although some information was difficult to locate due to the amount of paper work / receipts that is kept in the finance records. The Manager should consider ways of simplifying the home’s accounting procedures to make auditing easier. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 15 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 pleasant, safe and accessible place for people to live. EVIDENCE: Flat 4 is a purpose built, wheelchair accessible, second floor flat that is owned by Paddington Churches Housing Association. The home is located in a residential area of Westbourne Grove, 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 their own bedroom. Communal areas, bathrooms and toilets are shared. During this visit the Inspector saw all communal parts of the home and 2 people’s bedrooms, with their permission. All parts of the home are spacious, well decorated and comfortably furnished. People’s bedrooms are comfortable and very individual. There is a choice of two lounges and a large kitchen / dining room that provide a choice of communal spaces for people to use. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 16 The home has a sufficient number of bathrooms and toilets for residents’ use and these are located close to communal areas and bedrooms. One bathroom is equipped with a new Parker assisted bath and another has a wheelchair accessible shower. All parts of the home were clean and hygienic at the time of this visit. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.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, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are consistently enough staff on duty to meet the needs of people living in the home. Staff work well together but there is a need to increase the number of qualified staff. EVIDENCE: When the manager arrived at 09:00 two Support Workers were on duty. The Manager started her shift at 09:30 and two other staff came on duty at 12:30 and 2:30. The Inspector felt that the staff team worked well together to make sure that individual’s care needs were met and support was available when needed. The atmosphere was relaxed and people living in the home were given time and opportunities to make choices about the way they were supported with their care. Throughout the day the Inspector saw some very positive interactions between staff and people living in the home. Individual staff knew the care needs and routines of individual residents well and made sure that residents directed the delivery of care wherever possible. Information provided by the Manager before this inspection was evidence that 36 of staff working in the home are qualified to National Vocational Qualifications (NVQ) Level 2 or above. This percentage has been affected by a member of stff leaving since the last inspection. The Manager confirmed that 1 or 2 Support Workers would start their NVQ training later in the year. This should enable the Society to achieve the target of 50 staff during the current Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 18 financial year. The Manager also confirmed that the home currently has vacancies for two Support Workers and an Assistant Team Manager. All staff working in the home have a current Criminal Records Bureau (CRB) Enhanced Disclosure and the Manager confirmed that a record of these checks is kept in the home. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 19 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, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the required qualifications and experience. The organisation has sound policies and procedures that are regularly reviewed. EVIDENCE: The home’s registered Manager is qualified and experienced to run the home. The Assistant manager’s post is currently vacant and the Manager confirmed this will be advertised. The Manager has a clear understanding of the care needs of people living in the home, how these should be met and how people should be involved in planning the care they receive. The development of a more person-centred care planning system will further reinforce good practice that exists in the home. The Westminster Society carries out an annual quality assurance audit that involves people living in the home. A separate audit is completed for each home and an overall audit of the Society’s residential services is also completed. The Society has provided the Commission with a copy of the Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 20 quality assurance audit for Flat 4 and this includes clear evidence that people living in the home and other significant people have been asked for their views on the services provided in the home. Managers from the Society also carry out monthly monitoring visits to the home. Written reports are sent to the home’s Manager and the Commission following each visit. During this visit the Inspector checked a selection of records kept in the home, including care plans, health records, finance records and complaints. All records were up to date and well maintained by staff in the home. No urgent health and safety issues were noted during this visit, although staff should monitor the home’s hot water system to make sure that water is delivered at safe temperatures. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 21 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 2 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 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 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 2 3 X 3 X 3 X 3 2 3 Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 22 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. Standard YA1 Regulation 4 Requirement The home’s Statement of Purpose must be updated to provide residents and other people with accurate information about services provided in the home. Managers and staff must make sure that risk taking policies are reviewed regularly and especially when a person’s support needs change, to make sure that residents are cared for safely. Timescale for action 01/09/07 2. YA9 13 01/09/07 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. 3. Refer to Standard YA19 YA23 YA42 Good Practice Recommendations One person living in the home who is registered blind should be referred to the Rehabilitation Worker for assessment. The Manager should consider ways of simplifying the home’s accounting procedures to make auditing easier. Staff should monitor the home’s hot water system to make DS0000010878.V336291.R01.S.doc Version 5.2 Page 23 Great Western Road, Flat 4, 22-24 sure that water is delivered at safe temperatures. Great Western Road, Flat 4, 22-24 DS0000010878.V336291.R01.S.doc Version 5.2 Page 24 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. 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