Inspection on 14/08/07 for Little Road, 2

This inspection was carried out on 14th August 2007.

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

Other inspections for this house

Little Road, 2 05/10/06

Little Road, 2 21/12/05

Little Road, 2 07/09/05

Little Road, 2 20/01/05

Little Road, 2 23/09/04

Little Road, 2 02/09/03

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Chatsworth Care - Dawson House

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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 Little Road, 2 Hayes Middlesex UB3 3BT Lead Inspector Ms Jean Bovell Key Unannounced Inspection 14th August 2007 11:00 Little Road, 2 DS0000027065.V342542.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 Little Road, 2 DS0000027065.V342542.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. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Road, 2 Address Hayes Middlesex UB3 3BT 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 8848 9126 Tanners@lifeopportunitiestrust.co.uk www.lifeopportunitiestr Life Opportunities Trust Mrs Marva Denise Frederick Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2006 Brief Description of the Service: 2 Little Road is a residential home for six service users with learning disabilities. The home was registered in 1995. Shepherds Bush Housing Association owns the home and the care provider is Life Opportunities Trust. The home is a six bed roomed, semi-detached house, located in Hayes and is within walking distance to the town centre, the main line station and public transport facilities. The home has six single bedrooms. Two are on the ground floor. The ground floor has a lounge/dining area, which is comfortably furnished, for the service users. The kitchen, one small toilet, a shower room with a toilet and the utility/storage room are also on the ground floor. There is a bathroom with a toilet, and the office, on the first floor. The service users bedrooms are at least 14.1 square metres and are fitted with TV points and emergency call systems. There is a small rear garden, which is mostly lawn, with a patio area. Limited parking is available in the street. The staffing structure consists of a Registered Manager, a deputy, a senior, two full time and two part time day residential workers and one full time waking night staff. The staff provide support with personal care, practical tasks and leisure activities. There are two staff on duty at times when the majority of the service users are in the home, which includes the Deputy Manager. One staff is on a waking night duty, with an on call system in case of emergencies. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between 11:00am and 4.45Pm on 14th August 2007. The Deputy Manager and two residents were initially present. The Inspector was advised that one resident was at the day centre, another had been admitted to hospital and two residents accompanied by two care workers were on holiday. During the course of the inspection: the home’s policies, procedures and records were viewed. A tour of the building was undertaken and observations were made. Two residents and three care support workers who covered duty on separate day shifts were spoken with. The requirements that were made at the last inspection and all key Standards were examined. The Deputy Manager was co-operative and provided appropriate assistance throughout the inspection. What the service does well: What has improved since the last inspection? The separate financial records of residents are being clearly and accurately documented. People are regularly supported during activities of their choice within the community and the garden is being maintained. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Little Road, 2 DS0000027065.V342542.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 Little Road, 2 DS0000027065.V342542.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal files of residents were viewed at random and indicated that individual needs and aspirations were appropriately assessed prior to admission. EVIDENCE: The personal files relating to people who use the service were inspected at random. It was evidenced that prospective residents were referred to the home by Hospitals or Community Teams for People with Learning Difficulties and that background information, summary of assessed needs and care plans were submitted at the point of referral. It was indicated also that subsequent needs assessments was carried out by the home. Relevant professionals, relatives and prospective residents were involved in determining the capacity of the home to meet separate identified personal, healthcare, social and cultural/religious needs and interests. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 9 Life Opportunities Trust policy on Admissions was in place. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans that were drawn up in relation to individual residents were viewed and found to be satisfactory. Residents have good levels of choice in their day to day living and are supported in activities to enable them to participate in an independent lifestyle. EVIDENCE: A number of care plans were examined within individual residents’ files. It was reflected that separate healthcare, personal and social needs were assessed and actions and goals had been put into place within new care plan formats. Guidelines were not, however, accurately followed in all cases. These issues were discussed with the Deputy Manager who confirmed that appropriate staff training would be delivered. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 11 The Inspector was informed by the Deputy Manager that people who use the service were able to make decisions regarding their daily living routines such as activities, meals, personal purchases and what they wore each day. Residents have separate bank accounts but receive support from care staff when accessing state benefits and/or making chosen purchases. Personal interests and choices were also reflected in individual bedrooms. People were observed moving freely around the home and were offered lunch options at the time of the inspection. Risk assessments relating to activities identified within care plans had been carried out. These included swimming, going out using the walking frame, opening the front door, showering and making hot drinks. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service are supported in taking part in activities of their choice within the community and are encouraged to maintain contact with relatives. People are able to carrying out appropriate housekeeping tasks at the home. Varied and nutritional meals are being provided. EVIDENCE: The Inspector was informed by the Deputy Manager that residents regularly attended day centres, evening clubs and Church Services. These activities Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 13 include swimming, bowls, walks, dining out and the cinema were also reflected on care plans. An Activities Programme was on display and indicated that indoor activities included bingo, games, watching television and listening to music. One person attended the day centre and two people were on holiday at the time of the inspection. People who were at the home were observed making models, watching TV and/or listening to music in their separate bedrooms. An open visiting policy is in place and contact between residents and their respective relatives, advocates and/or friends is encouraged and facilitated. The Deputy Manager reported that people who use the service participated in housekeeping tasks such as setting the table, drying dishes, bringing down laundry and with supervision, tidying their bedrooms. Residents were observed preparing vegetables and making drinks. The home does not employ a cook but meals are prepared by care staff who are often assisted by residents. The menus were viewed and varied and wholesome choices were reflected. Light but nutritional lunch options were served to people at the time of the inspection. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service receive appropriate personal support and their health care needs are being met satisfactorily. Life Opportunities Trust policy and procedures on medication are in place and comprehensive. EVIDENCE: The Deputy Manager confirmed that several people required assistance with their personal care routines and that these tasks were carried out in privacy within bathrooms or separate bedrooms. People were, however, able to choose what they wore each day, hairstyles and make up. The health care needs of residents were recorded on their individual health care plans. It was reflected that access to General Practitioners, Dentists and Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 15 Chiropodist were arranged as required, and people were accompanied to hospital appointments. Residents were weighed on a regular basis and diets were modified where appropriate. Life Opportunities Trust policy and procedures on medication were in place and records were indicative of medication training being delivered to all care staff. Medicines were safely stored and administered and medication administration sheets were accurately recorded. The Deputy Manager confirmed that the people who use the service lacked the capacity to administer their own medication. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is satisfactory and accessible to residents and their relatives. The records indicated that residents were protected from abuse. EVIDENCE: The complaints procedure was clearly detailed, written and illustrated in a format suitable to meeting the needs of residents and accessible to relatives. No complaints had been made the home following the last inspection. Accident and incident records were inspected and were satisfactorily detailed. Policies and procedures relating to Abuse were in place and the records were reflective of staff training on the Protection of Vulnerable Adults being delivered. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and the atmosphere is calm and homely. EVIDENCE: The communal areas within the home are comfortably furnished, adequately spacious and suitable for shared and/or individual activity. The garden was tidily kept and accessible to people. There were no issues regarding the laundry. Overall, the home was found to be in good decorative order, clean, hygienic and essentially well maintained. The atmosphere was calm and homely. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It was reflected on training records that care workers are appropriately trained and qualified for meeting the needs of residents. The home’s recruitment policy was in place but staff recruitment files were not accessible at the time of the inspection. EVIDENCE: A total of eight care staff members are employed at the home. It was reflected on the rota that two care workers covered duty on each shift during waking hours and one care worker covered waking duty at night. The Inspector was informed by the Deputy Manager that a total of five members of the care staff had achieved National Vocational Qualification in levels 2 and/or 3. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 19 Training records were reflective of new care staff being inducted. It was also indicated staff training/refreshers delivered during 2006/2007 included Food Hygiene, Fire safety, First Aid, Medication and Protection of Vulnerable Adults. The Deputy Manager confirmed that staff recruitment files had been removed from the home and were consequently not available for viewing at the time of the Inspection. Care workers were observed being attentive and competent in responding to the needs of residents. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is organised and well run. Systems for undertaking effective quality assurance are in place. The records were indicative of the health and safety of residents being protected but Regulation 37 forms are not being submitted to the CSCI as required. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 21 EVIDENCE: The Registered Manager has been absent from the home for many months and a Registered Manager from another home within the Organisation initially covered the position on specific days each week. The Deputy Manager and/or Senior Care Worker are currently managing the day-to-day running of the home. It was evident on documents viewed that systems for carrying out effective quality assurance were in place. The views of residents, relatives and stakeholders were obtained and appropriate summaries had been compiled. Health and Safety records were indicative of checks regarding fire safety and water temperature being up to date. Fire drills were being undertaken on a monthly basis and environmental risk assessments had been undertaken. Accidents and incidents had been appropriately recorded but related Regulation 37 forms were not being faxed to the local Commission for Social Services Inspection offices. The delivery of staff training on Moving and Handling and Fire Safety was reflected on training records. Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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 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 X 34 2 35 3 36 X 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 17(3)(b) The Registered Person must ensure that staff recruitment files are available for inspection at the home. 37(1)(c)(d) The Registered Person must ensure that Regulation 37 forms are completed and faxed to the CSCI as required. Timescale for action 30/09/07 2. YA42 30/09/07 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 Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Little Road, 2 DS0000027065.V342542.R01.S.doc Version 5.2 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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