Inspection on 07/02/06 for Kneller Road, 131

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kneller Road, 131 21/06/06

Kneller Road, 131 14/09/04

Kneller Road, 131 07/05/04

Kneller Road, 131 27/02/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Kneller Road, 131 131 Kneller Road Whitton Middlesex TW2 7DY Lead Inspector Simon Smith Unannounced Inspection 7th February 2006 1:30 Kneller Road, 131 DS0000017375.V261283.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 Kneller Road, 131 DS0000017375.V261283.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. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kneller Road, 131 Address 131 Kneller Road Whitton Middlesex TW2 7DY 020 8893 4636 020 8893 4636 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) None United Response Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2005 Brief Description of the Service: The property is owned and maintained by Thames Valley Housing Association. The service is managed by United Response, a not-for-profit provider of community services for people with learning disabilities. Opened in 1996, the home is a single-storey property situated in a pleasant residential area. Whitton high street is close by and provides a range of shops, pubs and other community facilities. The home is set back from the road and approached via a driveway. Parking is available to the front of the property. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the course of a single visit and involved speaking to residents, the manager and members of staff. A sample of records was examined and a tour of the building made. The inspector was made welcome and wishes to thank residents and staff for their help during the inspection. The home met 19 of 24 National Minimum Standards assessed at this visit. Five Standards were almost met. Five Requirements and four good practice recommendations were made. Three Requirements were reinstated from the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Review residents communication profiles every six months. Provide person-centred planning training for staff. Clear the flower beds in the rear garden. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 6 Maintain the security of the property. Replace the bath in one ground floor bathroom. Hold staff meetings are more frequently. Provide individual supervision for all staff at least every two months. The home’s manager must submit an application for registration with the CSCI. Notify the CSCI of all accidents affecting residents. 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. Kneller Road, 131 DS0000017375.V261283.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 Kneller Road, 131 DS0000017375.V261283.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 Residents’ needs and strengths are effectively identified. Prospective residents have the opportunity to visit the home prior to admission and to move in on a trial basis. EVIDENCE: Each resident had an initial needs assessment on file, completed at the time of admission, which provided good information on individual strengths, needs and preferences. Needs identified through the assessment process inform residents’ care plans. Staff liaise effectively with other professionals and residents receive support to access specialist services where necessary. The design and layout of the home meets the needs of those who live there. Adaptations and specialised equipment have been installed where necessary to improve mobility. The home has appropriate procedures addressing assessment and admission. All prospective residents are able to visit the home before moving in. Admissions are made initially on a trial basis. There have been no admissions since the last inspection. Kneller Road, 131 DS0000017375.V261283.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, 7, 9 Makaton training has improved communication opportunities for residents. Residents receive support to make informed choices about their lives. Training in person-centred planning should be provided for staff. EVIDENCE: The last inspection report made Requirements about reviews of residents’ communication profiles and Makaton training for staff. Inspection of communication profiles at this visit found evidence that all but one of the resident’s communication profiles had been reviewed within the last six months. One profile had not been reassessed since August 2004 and still needed review. See Requirement 1. The deputy manager said that a speech and language therapist visits every two to three months to provide Makaton training for staff. The deputy manager reported that this training has realised benefits for several residents. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 10 Inspection of care plans confirmed that residents receive appropriate support to make informed choices about their lives. Staff demonstrated a good knowledge of residents’ needs and residents are able to access independent support should they wish. The home has a commitment to supporting residents towards achieving their individual goals. For example, a communication aid obtained by the home to improve one resident’s opportunities for communication has proved unsuitable. The deputy manager said that the speech and language therapist is investigating the availability of alternative communication tools that would better meet the resident’s needs. There was no evidence that any staff have attended training in person-centred planning. Whilst residents’ care plans reflect their needs appropriately, the home’s approach to care planning would benefit from using the techniques and tools used in the person-centred planning model. It is recommended that the home consider training in person-centred planning for staff. United Response provides appropriate guidance for staff in the identification and management of risk. Risk assessments are in place addressing specific activities undertaken by residents. These assessments are subject to regular review. Kneller Road, 131 DS0000017375.V261283.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): 11, 12, 13, 17 Residents participate in a range of activities appropriate to their needs and wishes. Residents are involved in their local community. The home’s menu is varied, well balanced and takes account of residents’ preferences. EVIDENCE: Staff reported that residents are encouraged to involve themselves in the routines of the home, such as laundry, cooking, shopping, and take part according to their needs and wishes. The deputy manager advised that two residents are particularly involved in this element of life at the home. Residents are actively involved in the local community, using shops, cafes, pubs and other community resources. Residents also attend structures day services, chiefly at Whitton Community Resource Centre, which provides an Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 12 range of in-house activities and outings. All residents have the opportunity to take part in at least one annual holiday The home has a leased vehicle and the deputy manager said that there are currently enough authorised drivers on the staff team. The home is considering changing the vehicle to another model, which it is felt may be better suited to residents’ needs. Responsibility for cooking and preparing food is shared amongst the staff team. This is appropriate given the size of the home. All staff attend basic food hygiene training as part of their induction process. Standards of food storage and kitchen hygiene were good. The advertised menu indicated that the home provides a varied and wellbalanced diet. Staff said that residents are encouraged to contribute to menu planning and that alternatives to the planned menu are available where required. Snacks and drinks are available at any time. Kneller Road, 131 DS0000017375.V261283.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): 19, 20 Staff liaise effectively with appropriate healthcare professionals regarding the care of service users. The recording and administration of medication was satisfactory. EVIDENCE: The home is required to manage challenging behaviour exhibited by some residents. Discussion with staff and the inspection of records demonstrated that the home has sought the input of appropriate healthcare professionals, including the community psychiatrist and community nurse, in managing these issues. In addition, the manager and deputy manager of the home have liaised with residents’ care managers about the response to the behaviour. Guidelines are in place for staff when working with residents who challenge the service and team meetings are used to brief staff on developments about the home’s approach. The deputy manager said that all staff, including agency staff, have attended appropriate physical intervention training within the last year. Residents’ care managers are informed of any incidents in which physical restraint is used. The community psychiatrist currently reviews residents’ medication every two weeks and speaks to the residents and staff. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 14 A number of residents have epilepsy. Care plans demonstrated that guidelines are in place for the effective management of the condition. Care plans also provided evidence that community healthcare professionals are involved where appropriate. For example the community nurse recently arranged a review for one resident following an increase in his seizures. At the time of inspection, one resident required daily visits from district nurses to address a specific healthcare need. There is an appropriate system for the storage and administration of medication. All medication coming into or leaving the home is recorded. There are clear protocols governing the administration of medication. There are no residents who self medicate. Inspection of medication and administration records revealed no omissions or errors. Kneller Road, 131 DS0000017375.V261283.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 Guidance is provided for staff in the recognition, prevention and reporting of abuse. EVIDENCE: The home operates within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’. The policy offers definitions of abuse and provides guidelines for staff in the recognition and reporting of abuse. United Response has developed a Whistle-blowing procedure, which provides an opportunity for staff to register any concerns they have about malpractice. Kneller Road, 131 DS0000017375.V261283.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): 24, 27, 28, 30 The home is comfortable, attractively decorated and well maintained. Sufficient, suitable toilet and bathroom facilities are provided. The security of the property should be improved. EVIDENCE: The home is situated in a pleasant residential area and has good access to shops, pubs and other community facilities. Communal rooms were welcoming and homely. The kitchen is domestic in character and provides sufficient space for residents to work alongside staff should they wish. All areas of the home were clean and hygienic. Toilet and bathroom facilities are accessible and are available in sufficient numbers to meet residents’ needs. The last inspection report recommended that the bath in one bathroom be replaced. This recommendation had yet to be implemented and is reinstated here. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 17 The flower beds in the rear garden would benefit from clearing to maintain the appearance of this area. The gate at the side of the property has a padlock attached but this was not locked at the time of inspection. It is recommended that the gate be padlocked when not in use to maintain the security of the home. Kneller Road, 131 DS0000017375.V261283.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): 32, 33, 34, 35, 36 Staff are appointed following an appropriate recruitment and selection procedure. New staff receive a good induction to the organisation and to the home. Staff meetings should take place more often. Staff undertake training appropriate to their roles. All staff must receive individual supervision at least every two months. EVIDENCE: The home had a vacancy for one support worker at the time of inspection. The deputy manager reported that agency staff are used to cover vacant shifts but that the home uses only agency staff able to offer a regular commitment to the service. Staff are encouraged to attend training relevant to their roles. Five staff have achieved the NVQ level 2 award. Two staff are currently working towards the NVQ level 3 award. The manager has completed the Registered Managers Award. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 19 Staff who were about to start work at the time of the last inspection have completed their Learning Disabilities Award Framework induction and will be registered on NVQ level 2 later this year. The last inspection report recorded that “the home aims to hold team meetings on a weekly basis, although minutes on file indicated that meetings have not been taking place as often as they should”. Inspection of records at this visit found that, although team meetings are used effectively by managers to give staff important information, meetings do not take place often enough. See Requirement 2. Three staff files were examined. All provided evidence of an appropriate recruitment procedure and pre-employment checks including Criminal Records Bureau disclosure, proof of identity and written references. Staff files also provided evidence that new staff have a good induction to the home and are required to successfully complete a six-month probationary period. Staff files indicated that some staff have not received one to one supervision often enough. The most recent supervision notes on file for one member of staff were dated September 2004. See Requirement 3. Kneller Road, 131 DS0000017375.V261283.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’s manager must submit an application for registration with the CSCI. The health and safety of residents and staff within the home is maintained. All accidents affecting residents must be notified to the CSCI. EVIDENCE: The home’s manager has yet to achieve registration with the CSCI and must submit an application for registration. See Requirement 4. The home has an appropriate fire detection system. Clear instructions for staff and residents in the event of a fire were prominently displayed. The kitchen is equipped with a fire blanket and extinguisher. The home was clean, hygienic and free of obvious health and safety hazards on the day of inspection. All COSHH products were stored appropriately. The home maintains an Accident book. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 21 One resident had an accident in the week prior to inspection. The resident received appropriate care and medical treatment. The home informed the resident’s care manager but did not notify the CSCI. See Requirement 5. The property is currently owned and managed by Thames Valley Housing Association. The deputy manager advised that the housing association is to transfer the management of the property to another agent in the near future. Kneller Road, 131 DS0000017375.V261283.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 X 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 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X 2 X X X X 2 3 Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15(2) Requirement Review residents communication profiles every six months. This Requirement is reinstated from the last inspection. Ensure that staff meetings are held more frequently, with minutes recorded. This Requirement is reinstated from the last inspection. Ensure that all staff receive individual supervision at least every two months. This Requirement is reinstated from the last inspection. The home’s manager must submit an application for registration with the CSCI. All accidents affecting residents must be notified to the CSCI. Timescale for action 30/03/06 2 YA33 12(5) 30/03/06 3 YA36 12(5) 18(c) 30/03/06 4 5 YA37 YA42 8 37 30/03/06 15/03/06 Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 24 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 4 Refer to Standard YA6 YA24 YA24 YA27 Good Practice Recommendations Staff should attend training in person-centred planning. The flower beds in the rear garden should be cleared. The gate at the side of the property should be padlocked when not in use. The bath in one ground floor bathroom should be replaced. Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Kneller Road, 131 DS0000017375.V261283.R01.S.doc Version 5.1 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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