Inspection on 04/07/05 for Greenford House

This inspection was carried out on 4th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Greenford House 22/03/07

Greenford House 07/02/06

Greenford House 05/01/05

Greenford House 22/06/04

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 Greenford House Monpekson Care Limited 38 Greenford Road Harrow HA1 3QH Lead Inspector Sue Mitchell Unannounced 4 July 2005 15:00 th 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 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 Stationary 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. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greenford House Address Monpekson Care Limited 38 Greenford Road Harrow HA1 3QH 020 8864 0626 020 8864 0626 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Monica Pryme Mrs Pek Kio Entwistle CRH PC - Care Home Only 3 Category(ies) of LD - Learning Disability registration, with number of places Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5.1.05 Brief Description of the Service: 38 Greenford Road is a private care home owned by Monpekson Care Ltd providing care and accommodation for three adults with learning disabilities. The home has been open since 1997. The house is semi detached on two floors. It is situated on a busy main road close to local shops and transport. There are three single bedrooms and bathroom on the first floor. There is a large lounge and dining room on the ground floor. The laundry is situated in the office. There is parking for two cars to the front of the building. There is a small rear garden with a lawned area and patio. The three service users have been there since the home opened and have become part of the community. The home has links with two other projects also owned by Monpekson Care Ltd. The service users attend a local day service as well as college. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out in the late afternoon when the residents were at home. One member of staff was on duty. the manager having gone out briefly Two staff came in for the afternoon shift. The inspector spent the first hour and a half talking to two of the residents. The other resident has limited verbal skills but was able to respond to questions and suggestions from staff and the other residents. The manager returned later on and spent time with the inspector assisting in the inspection process. The inspector also spoke to the two staff on duty. The inspection focussed on care plans, medication and other records, staff training and health and safety matters. What the service does well: What has improved since the last inspection? What they could do better: There was only one minor shortfall found during this inspection. The manager must ensure that key workers date the documents when the residents risk assessments are reviewed. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 standard(s) 1,2 Residents are given clear information about the home and the services it provides in a user-friendly guide EVIDENCE: The service user guide is now in place for the residents. It is written in clear, simple language using pictures and symbols to illustrate the homes facilities and services. The residents have lived in the home since it opened eight years ago. They have six monthly reviews and their care plans are updated as necessary. An admission policy and procedure is in place should a vacancy arise. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Residents are supported to be fully involved in decisions that affect their lives. They have the opportunity to participate in their reviews and the care planning process. They are supported to take risks both in and out of the home as appropriate. EVIDENCE: There has been little change in the care plans for two of the residents as they have remained stable and have achieved a degree of independence in many of their chosen activities of daily living. One person‘s care plan has been altered to reflect her current health care needs, which the home is very concerned about. The residents have six monthly reviews, which they attend. One person told the inspector about the review she had had the previous week. She was pleased about the nice things that had been said about her and that everyone was happy with her progress over the last few months. She said that her relative also came to the review and were pleased as well. Risk assessments were in place for all the residents, these were not dated, nor were their any indication that they had been reviewed. This is required. Residents meetings are held monthly. Minutes indicated that they were encouraged to make choices about activities both in and out of the home such as holidays. The two residents who spoke to the inspector discussed their plans for college, holidays and what they did during the week. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 Page 10 Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Residents are supported to choose from a range of social and leisure activities in the community. They are encouraged to attend local adult education colleges Residents are able to see family and friends as often as they wish, either at home or through visits EVIDENCE: Two of the residents stated that they enjoyed going to the local day centre and college. One person is able to travel independently around Harrow using the local buses, which he said he enjoyed doing. One person said that they had made a new friend at the day centre, which she was very happy about. They both attend clubs, which hold discos and organise trips out. One person had been on a boat trip with her friend. They had recently been to discos run by the Apple Club and Kodak. The residents have TV’s DVD and video players in their rooms and said they like to go to their rooms o rest or watch TV etc. The third person has been unwell and unable to participate in any social activities but staff were hoping she would be able to do more, as she got better. The residents spoke about their forthcoming summer holiday, which hasn’t been booked yet but said they wanted to go to the seaside. The manager said that she was taking two residents to enrol for courses at college for the Autumn term. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 Page 12 Two of the residents have family who come to visit or make regular contact by phone or letters. They both spoke with pleasure about their family contacts. The home has links with the other two homes in Harrow and they go to parties, barbecues etc at the homes. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 The resident’s health care is closely monitored by the staff and they are supported to attend all appointments. The homes medication arrangements ensure they are safe from harm EVIDENCE: There were detailed records of all the residents’ heath care appointments with outcomes of appointments recorded. The home has introduced health care plans for each person. The residents are supported to use community health care services. There is regular contact and support from the psychiatrist and the epilepsy clinic. The home has complied with all the requirements from the CSCI pharmacist’s inspection in January 2005. The home has changed its medication system to a monitored dosage system on the advice of the CSCI pharmacist. A new medication cabinet has been purchased. On inspection of the MAR sheets and dosage systems it was found that the pharmacist had not recorded two of the tablets for one person on the MAR sheet. The manager stated she would contact the pharmacist the next day to discuss the error and have it rectified. 9 Th e manger spoke to the inspector after the inspection to say that the error had been rectified by the GP and the pharmacist. The home has a contract with the supplying pharmacist. The manager was advised to contact the pharmacist to request training for staff on the new medication system. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 Page 14 Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Residents have the opportunity to express concerns or complaints through discussion with staff or at residents meetings. EVIDENCE: The resident’s complaints policy is written in a simple pictorial format using plain language. There are regular residents meetings and staff are available at all times to listen to any issues or concerns raised by the residents. The two residents who spoke with the inspector did not raise any concerns about the home. They did express personal concern for one person who has been unwell, but recognised that it would take time for this person to get back to their usual self. One person said he was going to talk to the manager about his concerns. There have been no complaints made to or about the home since the last inspection. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30 The residents live in a homely, clean and odour free environment, which reflects their personal tastes and choices. EVIDENCE: The inspector did not inspect the premises on this occasion. She met with one person in their bedroom, which was noted to be well decorated and furnished with family photos and personal possessions. The resident discussed some changes in furniture she having to the room. The communal areas are decorated and furnished in a homely manner. One person has some mobility problems and uses a walking frame when out of the house. She said she was cable to get around the house as long as she didn’t rush. The home is clean and free from odours. Gloves and protective aprons are provided for staff. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35 Residents are supported to lead their own lives by a stable staff team. Staff are provided with training and supervision to erk in safe and competent manner with the residents. EVIDENCE: The staff team at Greenford Road have worked in the home for many years and have provided a stable and supportive environment for the residents. The team comprises of regular part time staff. There are two staff on duty on each shift with a sleeping-in person at night. Staff carry out the household chores with the residents helping as much as possible. Two people have designated day at home to do their chores etc with staff. The manager works full time and is the proprietor of two of the other homes in the organisation. The residents spoke positively and warmly about a number of staff, saying how much they liked them and that they had been helpful to them. The atmosphere in the home was calm and relaxed with staff and residents interacting in caring and friendly manner together. Staff spoke positively about the developments the residents had made. They expressed concern for one person who has been unwell for some time and the ways in which they were encouraging this person to participate in house and community activities as much as possible. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 Page 18 One staff member said she had completed her NVQ 2. Both staff said they had attended training in medication, Protection of Vulnerable adults, challenging behaviour and first aid over the past few months. Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The resident’s safety health and welfare is protected and supported by regular checks and services to the equipment used in the home. EVIDENCE: The home carries out regular fire drills with the residents, which are recorded. Weekly safety checks are carried out and recorded. A fire risk assessment is in place. All certificates relating to the equipment and appliances used in the home were made available for inspection. These were seen to be up to date. The home recently had portable appliances testing of all the homes equipment including the resident’s personal electrical items. Some work is due to be carried out on moving the sockets on the skirting boards as a result of the PAT. The home has had visits from the Fire service and environmental health officer. There were no outstanding issues from these visits Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greenford House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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. Standard 9 Regulation 13 (4) Requirement The manager must ensure that risk assessmets are dated and reviewed regularly Timescale for action From 4.7.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 20 Good Practice Recommendations The manager is advised to contact the pharmacist to provide training on the new Monitored Dosage System Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th 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 Greenford House G62-G11 S17572 Greenford House V234783 040705 Stage 4.doc Version 1.30 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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