Inspection on 22/06/05 for 36 Harvey Road

This inspection was carried out on 22nd June 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

36 Harvey Road 28/07/06

36 Harvey Road 09/11/05

36 Harvey Road 05/10/04

36 Harvey Road 11/05/04

36 Harvey Road 05/02/04

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Harvey Road 36 36 Harvey Road Whitton Middlesex TW4 5LU Lead Inspector Louise Phillips Unannounced 22 June 2005 1:00pm nd 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. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Harvey Road 36 Address 36 Harvey Road Whitton Middlesex TW4 5LU 020 8893 3480 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) Owl Housing Limited Ms Elsa Karen Grieg Care Home only (PC) 5 Category(ies) of Learning disability (LD) registration, with number Learning disability over 65 years of age (LD(E)) of places Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 5th October 2005 Brief Description of the Service: 36 Harvey Road is a care home for up to five adults with learning disabilities, all of whom may be over 65 years of age. The property is owned and maintained by Richmond-upon-Thames Churches Housing Association, whilst the service is operated by Owl Housing. The home is situated in a pleasant residential area with access to local shops, cafes, pubs as well as parks. There is an adequate sized garden to the front and rear of the property. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day and took approximately 5.5 hours. A tour of the premises took place and staff and care records were inspected. On the day four members of staff and two service users were spoken to. What the service does well: What has improved since the last inspection? Since the last inspection progress has been made towards re-decorating the hallways and lounge areas of the home and these areas look bright, airy and welcoming. The deputy manager stated that these areas, plus the office are due to be re-carpeted within the next few weeks. The home has also worked to ensure that appropriate Portable Appliance Tests have been carried out on equipment around the home, and that a valid Certificate of Employers Liability Insurance is on display. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 6 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. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 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 Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 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) 2 and 4 The home has a clear assessment and admission process that is adapted to each service users’ needs. EVIDENCE: Earlier this year a new service user was admitted to the home. Referral information and social services assessment documentation was seen to be in place, along with records of initial meetings between the service user and staff at the home. The documentation relating to their admission details every stage of their move. The stages start with an introductory fortnight, where visits to the home occur along with the relatives also being able to visit and meet staff at the service. Over the subsequent four weeks the service user initially joined the other service users for their evening meal and progressing to overnight stays and then fully moving in. The records indicate that this process was carefully managed and the needs of the service user considered throughout. This is particularly where the service user was involved in identifying their own support needs regarding equipment they might need, preferred ways of communicating, lifestyle and cultural identity. An example of this was in the minutes of a meeting following the first couple of visits to the home, where a change of type of bed was identified and action was planned to address this. The assessment documentation for the new service user showed a clear identification of needs and support requirements, activities they like to do, Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 9 their strengths and the input of various external agencies involved in their care. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 10 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, 8 and 9 There is a clear and consistent care planning system in place to provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: Two service users files were examined and found to contain care plans in the form of ‘essential lifestyle plans’ that were drawn from the assessment information. Each plan records the preferences, routines and care required by the service user. The input of service users in their plan was evident with the provision of information regarding their preferred clothes, food choices, important people in their life and how they like to spend their time. One file provided individual information on hand signs/ symbols that the service user uses to communicate their wants and needs. Good interactions were observed, with staff adopting different methods of communication that was individualised to each service user. Examples of this ranged from talking up close to individual service users, clearly mouthed pronunciation, talking slowly and pointing to objects to clarify the intentions of the service user (as identified in the service user file above). Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 11 A record of weekly activities was seen for each individual service user. These are individualised and detail activities both inside and outside the home, such as sitting in the garden and going out for meals. Each service user has a comprehensive risk assessment that has been reviewed within the past three months. These were seen to contain management of risks surrounding manual handling and travelling in a taxi to the daycentre. In addition there is guidance around each individuals’ eating and drinking needs and pressure care management to ensure that these are managed safely. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 12 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) 11, 12, 13, 14, 15, 16 and 17 The staff have a good understanding of the service users’ support needs and assistance with activities is offered in such a way as to promote service users individual interests. The food provided by the home evidences that service users are offered choice and their nutritional needs are being met. EVIDENCE: The deputy manager discussed that service users were supported with consideration to their individual needs and abilities to pursue activities and interests. Weekly activity sheets in the service user files indicate the activities that they undertake throughout the week. These individual plans detail a variety of activities that service users pursue including attending various day centres, shopping, going to the pub or going to church. During the inspection one service user was observed independently playing a ‘stacking game’ with bricks, another sat outside enjoying the nice weather and others watching television. The deputy manager stated that the home has a minibus for use that is often used for impromptu outings on a sunny evening and at weekends. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 13 The deputy manager said that the home has recently linked with another Owl Housing service for joint activities to enable service users to develop their network of friends and pursue different activities. She further described that holidays are provided by the home according to individual wishes, with some planned as a group activity and others on an individual basis, dependant on the wishes of the service users. On the wall in the kitchen was displayed a weekly menu plan which clearly stated a choice of two options for each meal. The deputy manager stated that service users are involved in the choosing the meals by way of preferences for different meals and experimenting with new meals. The cupboards, fridge and freezer were seen to contain a variety of nutritious foods for consumption. On the day of inspection the weather was particularly hot and the home was found to be well-ventilated. The staff was seen to continually offer service users a selection of drinks and monitored the consumption of these. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 14 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) 18, 19 and 20 The health needs of service users are well met with evidence of good links with multi-disciplinary team members. The home needs to ensure that personal care is provided with respect for the privacy and dignity of service users. EVIDENCE: The personal care needs are identified in service user files in the format of guidance procedures and care plans. Documentation in the files demonstrates that multi-disciplinary team input is sought and utilised as necessary. In two service users files this was seen in relation to occupational therapy and physiotherapy involvement and their re-assessing care provision in relation to a service users’ changing needs. The deputy manager stated that the times for waking are flexible, dependant on the wishes of the service user and their daily plan of activities. On the day of inspection all the service users were appropriately dressed for the hot weather conditions, with light, loose fitting clothing and sandals observed on each individual. The staff on duty were seen constantly addressing the needs of the service users, such as helping them to sit outside/ inside dependant on wishes. Overall the staff team were observed displaying a caring attitude towards the service users, such as adjusting an individual’s position where they had slipped Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 15 down in their chair, adjusting the curtain to ensure the sun was not reflecting off the television and constantly attending to personal care needs. This was apart from on one occasion where a staff member was about to apply some cream to service users’ stomach in lounge area where other service users, staff and I were sitting. The deputy manager intervened appropriately and assisted with taking service user to a private area. It is required that the Registered Persons ensure that the privacy and dignity of service users is maintained at all times. The Medicine Administration Record (MAR) charts for two service users were checked and seen to correspond appropriately with the prescribed medication. Alongside each chart guidelines for the safe administration of each prescribed medication was given and individualised to each service user. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 16 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 and 23 The home must update the complaints procedure to ensure that it provides the required information. Staff are aware of issues surrounding the Protection of Vulnerable Abuse. EVIDENCE: There is a complaints procedure in place at the home that must be updated to include the contact details of the Commission for Social Care Inspection (CSCI). The home has the Owl Housing ‘Whistleblowing’ policy and it is recommended that this too includes the CSCI contact details. The home maintains a comprehensive record of all staff that have received training in the Protection of Vulnerable Adults (POVA). The records indicate that the training is carried out as part of the induction process for new staff. The deputy manager showed documentation indicating that all staff had received POVA training in March 2005. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 17 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, 25, 26, 27, 28, 29 and 30 The standard of the décor throughout the home is of a good standard and presents as an attractive, homely and comfortable environment for service users. The office area is very cramped and dedicated sleep-in facilities must be provided for staff. EVIDENCE: A tour of the building was carried out and the decor was found to be of a good standard throughout. Each service users has their own bedroom that is individually decorated and tastefully furnished. The accommodation within each bedroom is furnished with the necessary specialist equipment to support the individual service users in their daily activities and personal care needs. It was noted that the bathrooms on each floor had been decorated to look homely – with stencilling and pictures on the walls and homely furniture in place. The lounge/dining area is comfortable and homely, with good natural lighting throughout and with access into the secluded garden at the rear of the home. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 18 The deputy manager stated that the lounge and hallways had been redecorated within the past month and that the carpets in these areas, plus the office are due to be replaced in the next few weeks. The home was clean and hygienic on the day of inspection, with a comfortable and relaxed feel throughout. The office area was found to be very cramped, particularly by having a bed and the area being used as a sleep-in room by staff. The deputy manager stated that it is planned for a room on the first floor to be made into a sleep-in room but that this was not yet definite. It is required that adequate, dedicated sleep-in facilities are provided at the home for the staff. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 19 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) 33 and 35 The home is adequately staffed to ensure consistency of care to the service users. The staff team receive appropriate training to meet the needs of the service users. EVIDENCE: The deputy manager stated that the home currently has six full-time staff, with 2-3 staff on each shift. There are currently two vacancies for night staff and one carer vacancy for the day shifts. The home is currently using bank and agency staff to cover the vacant posts. The training records for the team were seen and indicated that all staff had completed training since the start of the year in fire safety, food hygiene, medication awareness and abuse awareness. The deputy manager demonstrated how she can access Owl Housing training to ensure that all staff are up-to-date in their training. One staff member is trained to NVQ level 3 and one trained to NVQ level 2 in Care. There is one new member if staff at the home who is currently going through the induction process which was seen to be planned weekly over a four week Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 20 period. The induction process was seen to cover a number of areas including orientation to each service users routine, infection control and orientation to the organisational policies. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 21 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) 39 and 42 The home does not demonstrate that the views of relatives, professionals or any stakeholders of the service are sought. Good progress has been made to ensure the home meets the health and safety requirements. EVIDENCE: The home does not currently have a quality assurance format for seeking the views of relatives and professionals involved with the service and it is required that a system for seeking feedback and using this to develop the service is implemented. The care files indicate the involvement of service users in their essential lifestyle planning. Copies of correspondence in the files demonstrate that the home informs relatives and service users of changes in the staff team and the plans for re-decoration. The deputy manager stated that the home works closely with each service user to ensure that the service they receive is what they want with regard to activities, food, clothes and personalising of bedrooms. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 22 Since the last inspection the home has ensured that appropriate Portable Appliance Tests have been carried out on equipment around the home, and that a valid Certificate of Employers Liability Insurance is displayed. Records are maintained of daily fridge and freezer temperature checks, the temperature of the meals prepared for service users. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 23 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 x 3 x 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harvey Road 36 Score 2 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 24 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 YA18 Regulation 12(4)(a) Requirement The Registered Persons must ensure that the privacy and dignity of service users is manitained at all times. The Registered Persons must ensure that the complaints procedure inludes the contact details of the Commission for Social Care Inspection (CSCI). The Registered Persons must ensure that adequate, dedicated sleep-in facilities are provided at the home for staff. The Registered Persons must implement a quality assurance system to review the quality of the service and seek feedback from service users, their representatives and all parties involved with the service. Timescale for action 31/07/05 2. YA22 22(7) 31/07/05 3. YA24 23(3)(b) 31/07/05 4. YA39 24(1) 30/09/05 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 YA23 Good Practice Recommendations It is recommended that the Whistleblowing’ policy includes G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 25 Harvey Road 36 the CSCI contact details. Harvey Road 36 G54-G04 S17371 Harvey Road V228926 230605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Ground Floor 41-47 Harfield Raod Wimbledon London SW19 4RD 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. 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