Inspection on 02/10/06 for Laurel Gardens, 14

This inspection was carried out on 2nd October 2006.

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

Other inspections for this house

Laurel Gardens, 14 23/01/06

Laurel Gardens, 14 15/09/05

Laurel Gardens, 14 14/02/05

Laurel Gardens, 14 28/09/04

Laurel Gardens, 14 06/02/04

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 Laurel Gardens, 14 Hanwell London W7 3JG Lead Inspector Ms Jean Bovell Key Unannounced Inspection 2nd October 2006 11:45 Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurel Gardens, 14 Address Hanwell London W7 3JG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8579 6869 Ealing Consortium Limited Mrs Ursula McGinty Care Home 3 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: 14 Laurel Gardens is a residential home for three service users with learning disabilities. The home was registered in 1991. Acton Housing Association owns the home and the care provider is Ealing Consortium Limited. The home is located in Hanwell and is within walking distance to the local shops and cafes. West Ealing and Ealing Broadway shopping centres can be accessed by public transport facilities. Hanwell mainline station is located nearby. The lounge, kitchen/dining area, a laundry room, an en suite shower room and one of the three service users bedrooms are situated on the ground floor. There is small rear garden with wood covered patio. Two service users bedrooms, a staff sleeping-in room, an office and an en suite bathroom are on the first floor. The home is not accessible to wheelchair users. Fees are £1450.50 per week. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was carried out between 11:45am and 4pm on 2nd October 2006. One care support worker and two service users were at the home. The Inspector was informed that the Registered Manager was on sick leave and that one service user was at work. During the course of the Inspection, the home’s records, documents, policies and procedures were viewed, a tour of building was undertaken and observations were made. The Inspector spoke to three service users and two care support workers all of whom were at the home during the later stages of the inspection. The requirements that were made at the last inspection and all key Standards were inspected. Two care support workers were co-operative and provided appropriate assistance throughout the inspection. What the service does well: The service users were appropriately dressed and appeared comfortable and very much at home within their environment. The service users reported being happy with the overall care they received at the home and were observed to relate in a friendly manner with care support workers. Two care support workers expressed satisfaction with the level of training and support they received at the home and were observed being competent in meeting the needs of the service users. In particular service users were treated with respect and received support in pursuing separate interests and aspirations. All records viewed were satisfactory and indicated that the safety and welfare of the service users were being protected. Overall, the home was found to be clean, hygienic and well maintained. The atmosphere was calm and homely. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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 Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. Prospective service users are appropriately assessed prior to admission. EVIDENCE: It was evidenced on service users files that following referral and background information being submitted by placing authorities in relation to prospective service users, a care needs assessment was undertaken by the home. Service users, relatives, carers, social workers and medical professionals – where appropriate - participated in identifying and determining the home’s capacity to meet specific needs and aspirations. Initial care plans and related risk assessments were subsequently undertaken. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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 and 9. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. Care plans and associated risk assessments are being satisfactorily undertaken and service users receive support and encouragement in making decisions. EVIDENCE: It was indicated on care plans viewed that separate personal, social and educational needs were being identified and that appropriate action plans and set goals were put into place. Care plans were reviewed on a six monthly basis and service users, relatives, advocates and social workers were invited to attend review meetings. A care support worker confirmed that service users were able to make decisions regarding times they awoke/retired at night, activities, personal purchases, meals and clothing. All bedrooms were lockable and reflected individual choices and preferences. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 10 Service users moved freely and comfortably around the home. They were supported during shopping trips and were observed being offered choice in relation to meals. It was evidenced on service users files that risk assessments in relation to specific independent activities such as travelling on public transport and personal care, had been undertaken. All risk assessments were regularly reviewed. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. Service users are supported in participating in appropriate indoor and outdoor activities and they are able to maintain contact with relatives and friends. Service users are being treated with respect and are provided with varied and nutritious meals. EVIDENCE: The records were reflective of service users being supported in finding and maintaining employment and attending college. It was indicated also that service users were being regularly supported during separate and joint activities within the community. These included shopping, meals out, the cinema, annual holidays and day trips. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 12 Service users attended church services on a Sunday and were able to pursue hobbies and interests such as books, writing, drama and keeping pets. They were observed being involved in separate activities including viewing books of interest, watching television and copy writing and were supported during individually chosen outdoor activities at the time of the inspection. An open visiting policy is in place and contact with relatives, friends and advocates are encouraged and facilitated. All bedrooms are lockable and care support workers were observed knocking on doors prior to entering and interacted with service users in a respectful manner. A care support worker confirmed that service users were able to make and/or receive personal telephone calls and receive confidential mail. Housekeeping tasks undertaken by service users included making drinks, preparing vegetables, washing up and tidying bedrooms. The menus were reflective of wholesome and varied cooked meals being prepared at the home. Service users were observed being given meal options during the inspection. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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, 19 and 20. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. Service users receive appropriate assistance with personal care and their physical and emotional health care needs are being met. A requirement under Standard 20 relating to bottled medication had not been complied with. EVIDENCE: It was reported by a care support worker that service users received assistance or prompting with personal care as required and that all personal care tasks were undertaken in privacy within bathrooms or individual bedrooms. Service users made independent decisions regarding clothing, hairstyles and make up. Care plans were indicative of annual comprehensive health care, dental and eye checks being carried out. Access to the G.P. and Chiropodist were arranged when required and service users were supported during hospital appointments. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 14 The home’s policy and procedures on the administration of medication were in place and a care support worker confirmed that medication training had been delivered to all members of the care support staff team. The storage, disposal and administration of medicines were satisfactory but a requirement relating to dates of opening being recorded on bottled medication had not been met. None of the service users were self-administering their medication at the time of the inspection. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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): 22 and 23. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. The complaints procedure is satisfactory and service users are being protected from abuse. A requirement under Standard 23 at the last inspection has been met. EVIDENCE: The complaints procedure is clear, concise and accessible to service users and their relatives. It was evidenced in the complaints book that one complaint was made following the last inspection and was appropriately investigated and resolved. Separate incidents and accident books were in place and complied with a requirement under Standard 23 at the last inspection. The service users are supported in handling their own finances. The financial records of three service users were inspected and found to be satisfactory. A poster on health and safety was on display and the home’s written policy and procedures on abuse and London Borough of Ealing manual on the protection of vulnerable adults were in place. The records indicated that training on the protection of vulnerable adults had been delivered to all members of the care support staff team. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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 and 30. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. The home is comfortable and well maintained. EVIDENCE: The communal areas of the home are attractively decorated, appropriately furnished and suitable for shared and/or individual activity. The garden was tidily kept. There were no issues regarding the laundry. Overall the home was clean, hygienic and well maintained. The environment was calm, homely and safe. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 and 36. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. Staffing levels are adequate and support workers are appropriately trained and competent in meeting the needs of the service users. Regular staff supervision is being delivered. EVIDENCE: It was indicated on the staff rota that two care support workers were on duty during waking hours and there was one sleeping staff cover at night. Staffing levels at the time of the inspection were adequate and care support workers were observed being competent and attentive. The records were reflective of staff training delivered during 2006 included moving and handling, epilepsy, food hygiene, protection of vulnerable adults and fire safety. The Inspector was informed by two care support workers that they operated within a supportive staff team and received regular supervision from the Registered Manager. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 18 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, 39 and 42. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. The home is well run and the health, safety and welfare of the service users are being satisfactorily protected. Self-monitoring is being adequately undertaken. EVIDENCE: It was evidenced on records viewed that the home was organised and well run. Care support workers reported that the Registered Manager was open, approachable and supportive. Systems were in place for self-monitoring and it was evidenced on documents viewed that monthly quality assurance audits were being undertaken. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 19 Health and safety checks including those for fire safety, fire drills, gas maintenance, portable electrical appliances and legionella were up-to-date. Environmental risk assessments were appropriately carried out and staff training on fire safety, moving and handling and food hygiene, had been delivered. Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 21 YES 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 YA20 Regulation 13(2) Requirement The Registered Person must ensure that opened bottled medication are dated and signed. Previous timescale 24/02/06. Timescale for action 26/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Laurel Gardens, 14 DS0000027734.V313865.R01.S.doc Version 5.2 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. 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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