Inspection on 07/02/06 for Greenford House

This inspection was carried out on 7th February 2006.

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 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

Greenford House 22/03/07

Greenford House 04/07/05

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 Middlesex HA1 3QH Lead Inspector Monica Saunders Unannounced Inspection 7th February 2006 08:30 Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 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 Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 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. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Greenford House Address Monpekson Care Limited 38 Greenford Road Harrow Middlesex HA1 3QH 0208 864 0626 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) Ms Monica Pryme Mrs Pek Kio Entwistle Mrs Pek Kio Entwistle Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 LD Date of last inspection 4th July 2005 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 DS0000017572.V280172.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced conducted during the morning and ended early afternoon on 7 February 2006. The manager was present throughout the inspection. The inspection included discussion with staff and one resident, direct observations, inspection of records and a tour of the premises. It was not possible to significantly communicate with the other two residents who were on the premises, and therefore this report does not incorporate their views. What the service does well: What has improved since the last inspection? What they could do better: One previous recommendations is still outstanding because the manager is waiting for the chemist to visit. The manager is advised to contact the pharmacist to provide training on the new Monitored Dosage System Future monitoring of service quality assurance questionnaires must be dated. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 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 DS0000017572.V280172.R01.S.doc Version 5.1 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 Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4, 5 Information is received about the prospective resident prior to admission, and the home carries out an assessment to ensure they meet the needs of the resident. Residents receive a pre.placement contract, written agreement and terms and conditions of placement EVIDENCE: No new residents have been admitted to the home since the last inspection The home has written guidance for staff for the admission of prospective residents. Individual files were sampled during the inspection. The home collects information, which they use to determine the suitability of the home as a placement for prospective residents. The contracts viewed were user-friendly and contained illustrations. A copy was on the file of each residents file sampled together with a pre.placement contract and a copy of the homes terms and agreement. Each copy of all agreements had been signed by the home and the resident. The manager has updated the risk assessments of residents. The homes policy and procedures give prospective residents the opportunity to test drive the home before moving in . Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 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 the following standard(s): 6, 8, 10 Individual care plans , risk assessme are in The home endeavours to support residents to consult with them about the service and provide regular and timely residents meetings. Residents information about them is handled sensitively and records are secured. EVIDENCE: Each resident’s file sampled contained an updated copy of a care plan. The care plan contained information in relation to the specific care needs of the residents, which included their lifestyle, history, interests, preferences and assessment of risks. From discussions and observations during the inspection, staff worked consistently with the aims of the care plans. Risks assessments viewed have been updated, particularly in light of one resident’s onset of alzeheimer and their deteriorating.condition The home’s House Meetings book was examined and demonstrates that regular monthly house meetings are held and decisions are recorded. Discussion with one resident who was quite vocal in her communication said “we have resident meetings sitting around the table with refreshments”, and went on to give examples of some of the residents discussions i.e “deciding Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 10 what activities we want to plan”. “Decide whether we go to the seaside, going away on holiday to France”. The manager said that she is aware that some of the resident’s capacity to fully participate is limited, and takes this into consideration whilst facilitating these meetings. Discussion with one resident indicated that residents were able to communicate sensitive issues to staff. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 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 the following standard(s): 14, 16, 17 Residents take part in activities and use community resources. Residents attend day centres, providing them the opportunity to develop socially to take responsibilities to develop further in their daily lives. Residents have a varied and balanced meal they enjoy. EVIDENCE: Each resident has a day care programme which is included in their care plan in thefiles sampled. Residents have access to leisure resources in the community. One resident confirmed that staff took her shopping, to restaurants, cinema, bingo, coach trips and to the hairdressers. One resident said she helps to choose the meals provided by the cook, and said, “If there are things I don’t like, I can ask for something else”. The pre planned menu was viewed and looked quite varied and appetising. The manager said that she uses menu guidelines for setting meals together with the suggestions from the residents input and the menu is then drawn up weekly. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 12 The manager pointed out that one of the residents does his own cooking at college and the home supports this by giving him money to purchase his ingredients. A female resident was observed making her own sandwiches for her packed lunch to take to the day centre. One resident was observed being offered a selection of cereal for breakfast by staff. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 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 the following standard(s): 18,21 Residents receive personal care and support in a way they prefer. Resident’s onset of failing health is handled with respect and in conjunction with health professionals. EVIDENCE: Discussions with resident’s, staff and observations indicate that staff are committed to a service that promote privacy, respect and dignity to residents preferences in relation to their personal care. Daily living routines were flexible in the home, and the home supports and encourages residents to carry out personal care tasks independently and staff provide support as and when necessary. Bedrooms were all single rooms with suitable locks fitted to doors to ensure privacy. One resident said that she locks her door when she leaves the home and is able to keep her key she said “I am independent, they want me to be independent”. On further discussion with the resident she said she is able to go into the bathroom and carries out her own personal care and brushes her own hair. “Staff help me to put on my nail varnish”. One resident has been diagnosed with the onset of alziehmer. The home is closely monitoring and re assessing whether they can continue to care for her. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 14 The home has close liaison with the psychiatrist to assist them in managing her behaviour. The manager must ensure that staff are not overstretched in managing the behaviour beyond their knowledge and skills The manager must ensure that closer liaison is kept with health professionals to link with the homes risk assessment Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 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 the following standard(s): 23 An adult protection policy and protection of vulnerable adults training for staff contribute towards the safety of residents EVIDENCE: A member of staff confirmed that staff had attended training on adult protection and said she has a clear understanding of safer caring practices and of what to do in case of allegations or suspicion of abuse. The staff member said she was aware of the staff whistle blowing policy and of the POVA (protection of vulnerable adults) procedure. The manager said the staff are aware of the challenging behaviours of the residents, and said the staff have been rostered to attend training on dementia to support them in gaining a better understanding to the resident’s increasing challenging behaviour. The home should consider an advocate to visit residents regularly as an additional safeguard because some of the residents have limited family contact. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 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 the following standard(s): 25, 28 Residents have their own individual rooms decorated and arranged to suit their needs. The home has sufficient shared space to compliment and supplement the residents individual rooms EVIDENCE: The home as adequate space and meets the national minimum standards requirements regarding private, communal space, and bathroom facilities. The residents bedrooms viewed were personalised and fully furnished. Each bedroom is of single occupancy and has a washbasin fitted. The manager said window restrictors are not fitted to windows because the windows consist of a large pane of glass with a fan light window to the top section. Observations indicate that the window is too high for the residents to climb out if the window was opened fully. The windows are of an adequate height to allow the residents access to open the windows. Because of the winter months and during the time of inspection the garden was not regularly used. On examination an area designated in the garden is used by a resident for smoking, which was clean on the day of inspection. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 17 Observation indicated that during the summer months the garden area would give the residents adequate additional space to use at their leisure. The kitchen area is of a reasonable size to allow more than one resident alongside staff to use facilities. The communal lounge and dinning area is adequately furnished to meet the challenging demands of the resident’s behaviour. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 36 The recruitment process protects the welfare of the residents. Individual supervision sessions offer support and training to staff. EVIDENCE: Discussions with the manager and the training files that were examined indicated that the home provided training for staff. For residents who have specific needs such as dementia the home ensures that staff receive training and information about these conditions. The staff recruitment files were sampled and those examined contained details of two referees, criminal record bureau checks and terms and conditions of employment. Individual training courses were viewed and indicated training received by staff, such as: Health & Safety Moving & Handling First Aid Food & Hygiene Safe Handling of Medication POVA Greenford House 27/8/05 15/7/05 20/1/05 4/9/05 4/9/05 14/10/05 DS0000017572.V280172.R01.S.doc Version 5.1 Page 19 Autism Challenging Behaviour Learning Difficulties Prevention of Infection and Control 30/8/05 24/3/05 24/8/05 21/10/05 Staff confirmed they received regular supervision and examination of staff records indicate that supervision is given regularly. Staff meetings are held monthly. Examination of the staff meeting minutes recorded that they included an overview of residents present state/condition and informing staff of forthcoming training dates. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42, 43 The home is well managed and the registered manager has a good understanding of the residents needs, likes and dislikes, and approaches the residents in a supportive way. Service records were up-to-date. The home has made good effort to put quality assurance monitoring in place. EVIDENCE: The Registered Manager is currently completing the Management & Care Award in level NVQ 4. Resident spoken to said the manager was approachable and is “always there to talk to even though I have a key worker”. The servicing records were randomly checked. The fire and electrical were carried out May 2005. Fire alarm checks were in place. The examination of the testing for Legionalla certificate had not been requested but should be made available for the next inspection. Reg 26 visits are carried out monthl, copies of reports were viewed on file. A quality assurance questionnaire had been carried out but no date was on the Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 21 copies held on file. The home must ensure that all future quality assurance monitoring must be dated. Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 22 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 3 ENVIRONMENT Standard No Score 24 x 25 3 26 x 27 x 28 3 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x 3 x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 3 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x x 2 3 x x x x 2 2 Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 23 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 YA21 Regulation 13(2)a Requirement The manager must ensure that staff are not overstretched in managing the behaviour beyond their knowledge and skills The manager must ensure that closer liaison is kept with health professionals to link with the homes risk assessment Future quality assurance questionnaires must be dated Testing for Legionella certificate to be made available at next inspection visit Timescale for action 30/04/06 2. 3. YA39 YA41 24(1)(a) 13(4)(c) 30/06/06 30/04/06 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 YA20 Good Practice Recommendations The manager is advised to contact the pharmacist to provide training on the new Monitored Dosage System Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greenford House DS0000017572.V280172.R01.S.doc Version 5.1 Page 25 - 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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