Inspection on 05/10/06 for Little Road, 2

This inspection was carried out on 5th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Little Road, 2 14/08/07

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

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 Little Road, 2 Hayes Middlesex UB3 3BT Lead Inspector Ms Jean Bovell Key Unannounced Inspection 5 and 6th October 2006 th Little Road, 2 DS0000027065.V313868.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.V313868.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.V313868.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 www.lifeopportunitiestrust.co.uk 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.V313868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st December 2005 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 Registered Manager. One staff is on a waking night duty, with an on call system in case of emergencies. Little Road, 2 DS0000027065.V313868.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 11:45am and 4:35pm on 5th October 2006 and between 12:15 and 1:15 on 6th October 2006. The Registered Manager, one care support worker and three service users were present at the initial stage of the inspection. The Inspector was advised that three service users were attending the day centre. During the course of the inspection, the home’s records, documents, policies and procedures were viewed. Observations were made and a tour of the building was undertaken. Four service users and three care support workers were spoken with. The Requirements that were made at the last inspection and all key Standards were examined. The Registered Manager and/or a senior support worker were co-operative and provided appropriate assistance throughout the inspection. What the service does well: What has improved since the last inspection? Six requirements were made at the last inspection and all had been complied with. These related to staff training, written policies and procedures, COSSH materials and carpets. Little Road, 2 DS0000027065.V313868.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. Little Road, 2 DS0000027065.V313868.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.V313868.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): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. The service users’ guide and statement of purpose are satisfactory. Appropriate assessments are undertaken by the home in relation to prospective service users and include prospective service users being invited to the home. Signed contracts/statement of terms and conditions regarding individual service users are in place. EVIDENCE: The statement of purpose and service users’ guide were in place and contained the required information. The Registered Manager confirmed that both documents were in the process of being reviewed. The records were reflective of appropriate assessments being undertaken by the home in relation to prospective service users. Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 9 It was indicated that relatives, social workers and medical professionals, where appropriate, were involved in the process of determining the capacity of the home to meet separate identified needs and aspirations. Prospective service users were required to visit the home prior to admission and were initially placed on a trial period of six weeks. Written confirmation that specific assessed needs and aspirations would be met at the home was provided to prospective service users and/or their relatives and signed contracts/statement of terms and conditions were evidenced within service users files. Little Road, 2 DS0000027065.V313868.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 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 risk assessments are being satisfactorily undertaken and service users are able to make decisions regarding their daily routines. EVIDENCE: It was evidenced on care plans viewed that separate personal, social and healthcare needs were assessed and that action plans and set goals had been put into place. Risk assessments in relation to specific activities identified within care plans were undertaken and were regularly reviewed in conjunction with care plans. The records were indicative of service users being able to make decisions regarding activities, meals, personal shopping, clothing, hairstyles and makeup. Individual choice was also reflected in their personalised bedrooms. Little Road, 2 DS0000027065.V313868.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 adequate. This judgement had been made using available evidence including a visit to this service. Opportunities for participation in day resource activities within the community are satisfactory but indoor and weekend activities organised by the home are limited. Contact with relatives and friends are being maintained. The rights of service users are respected and varied and nutritional meals are provided. EVIDENCE: The Inspector was informed by a senior support worker that five service users attended a resource centre where they received opportunities for learning and pursuing individual interests. Two service users were members of an evening club. Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 12 Annual holidays and short breaks were arranged and activities within the community such as shopping trips and meals out were reflected on service users records. However, organised indoor and weekends were rarely indicated. Service users attended a day resource centre and one service user was accompanied to a holiday abroad during the course of the inspection. Those who were at the home sat in the lounge and continually watched TV. No organised activity or meaningful engagement between service users and care support staff were observed. An open visiting policy was in place and the records indicated that contact with relatives and/or friends were encouraged and facilitated. A senior support worker confirmed that none of the service users were involved in personal relationships although several had developed special friendships within the day centre. All bedrooms were fitted with individual locks and it was reported by a senior support worker that a few service users chose to hold a key and lock their bedroom. Service users were also able to make private telephone calls and receive confidential mail. Service users were observed being able to move freely and comfortably around the home. Service users made tea, assisted with the preparation of vegetables and called for support in making a bed at the time of the inspection. Varied and wholesome meals were reflected on the menus and were prepared at the home during the inspection. However, snacks were not seen to be readily available. Little Road, 2 DS0000027065.V313868.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. The service users are being provided with appropriate personal support and their health care needs are being met. The policy and procedures regarding medication are satisfactory but dates of opening were not stated on bottled medication. EVIDENCE: A senior support worker confirmed that the dignity and privacy of service users were respected and that appropriate assistance, monitoring or supervision were provided as required during personal care routines but that all service users were able to make choices regarding clothing, hairstyles and makeup. It was evidenced on care plans viewed that separate health care needs were regularly assessed and appropriately met. Annual comprehensive health care, dental and eye tests were organised. General practitioner and chiropodist Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 14 appointments were arranged when required and service users received access to psychiatrists, occupational therapists and district nurses. A service user was supported during a medical appointment at the time of the inspection. The home’s policy and procedures on the administration and control of medicines were in place. The storage and administration of service users medication were satisfactory but dates on which bottled medicines had been opened were not recorded. The service users that are currently placed at the home do not have the capacity to administer their medication. Little Road, 2 DS0000027065.V313868.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 adequate. This judgement had been made using available evidence including a visit to this service. The complaints procedure is satisfactory. Financial recordings are not consistently clear. Requirements under Standard 23 at the last inspection had been complied with. EVIDENCE: The complaints procedure was appropriately detailed and it was reflected in the complaints book that no complaint had been made to the home since November 2000. Recordings in the accident and incidents books were satisfactorily detailed. The London Borough of Hillingdon’s adult protection policy was in place. It was evidenced on records viewed that recent training on the protection of vulnerable adults had been delivered to all members of the care support staff team and complied with requirements under Standard 23 at the last inspection. The service users are in receipt of state benefits and receive support with handling their own finances. Individual financial records were examined and figures were not – in each case - clearly or appropriately entered. Repeated particular patterns in relation to service users’ expenditure were identified by Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 16 the Inspector and referred to the London Borough of Hillingdon Safeguarding Adults Team for separate consideration. Little Road, 2 DS0000027065.V313868.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 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 well maintained but the garden is not being adequately cleaned. Requirements under Standards 24 and 30 at the last inspection have been met. EVIDENCE: The accommodation at the home is adequately spacious, comfortably furnished and suitable for shared or individual activity. The communal areas had been redecorated and carpets were replaced. This complied with a requirement under Standard 30 at the last inspection. There were no issues regarding the laundry. COSHH products were safely stored and met with a requirement under Standard 24 at the last inspection. Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 18 Although there was an accumulation of litter in one area of the garden, the home’s interior was clean, hygienic and well maintained. The atmosphere was calm and homely. Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 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 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, 34, 35 and 36. Quality in this outcome area is adequate. This judgement had been made using available evidence including a visit to this service. Care support workers are appropriately supervised and qualified but are not appropriately trained for meeting the emotional needs of the service users. In addition, the Registered Manager and deputy manager were both accompanying a service user on holiday abroad, which did not appear to be a satisfactory arrangement regarding the supervision and support for the remaining staff in the home. The recruitment policy and practices are satisfactory. EVIDENCE: The Registered Manager confirmed that six members of the care support staff team had achieved level 2 National Vocational Qualification in health and social care. A number of recruitment files were examined at random and were found to contain all the required documents such as photo-identification, application forms, references, CRB disclosure certificates and signed contracts/statement of terms and conditions. Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 20 Individual training programmes were in place and it was indicated that all new staff members were inducted and received subsequent mandatory training. Staff training delivered during 2006 included first aid, manual handling, fire safety, food hygiene and protection of vulnerable adults. The records were reflective of regular supervision being delivered to care staff. Monthly staff meetings were also held. Members of the care support staff team who were spoken with expressed satisfaction with the level of training, support and supervision being delivered at the home. Although support workers were competent in responding to physical needs of the service users, their emotional needs were not seen being appropriately met. In particular stimulation in the form of meaningful interactions or organised activity were not observed at the time of the inspection. Both the Registered Manager and deputy manager were in the process of going abroad the following day for a week taking a service user on holiday. This did not seem to the Inspector the most appropriate line management arrangements with both the two most senior staff being away from the home at the same time. Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 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 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 being adequately run and self-monitoring is being satisfactorily undertaken. The health and welfare of the service users are being safeguarded. EVIDENCE: The Registered Manager an experienced registered general nurse. She has been in post for three years and has obtained the Registered Manager’s Award. Members of the care support staff team who spoke to the Inspector reported that the Registered Manager was open, approachable and supportive. Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 22 It was evidenced on documents viewed that there were systems in place for effective self-monitoring and that appropriate questionnaires were sent out to relatives, GPs and district nurses on 29th September 2006. All records relating to health and safety checks were up-to-date. These included tests for fire safety/drills, legionella, portable electrical appliances and gas maintenance. Environmental risk assessments had been satisfactorily undertaken. Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 2 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 2 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 Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 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 YA14 Regulation Requirement Timescale for action 30/11/06 2. YA20 3. YA23 4. 5. YA30 YA35 6. YA36 16(2)(m)(n) The Registered Person must ensure that appropriate indoor and outdoor activities particularly on weekends - are regularly organised. 13(2) The Registered Person must ensure that dates on which bottled medication are opened are recorded and signed. 17(a) The Registered Person must ensure that service users’ expenditure is clearly documented within individual financial records. 23(2)(o) The Registered Person must ensure that the rear garden is tidily maintained. 18(1)(c)(i) The Registered Person must ensure that appropriate training for meeting the emotional needs of people with learning/physical disabilities is delivered to the care support workers. 18(1)(a) The Registered Person must ensure that suitably qualified, competent and experienced persons are working in the care home at all times. 15/11/06 15/11/06 15/11/06 30/03/07 30/10/07 Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 25 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.V313868.R01.S.doc Version 5.2 Page 26 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 Little Road, 2 DS0000027065.V313868.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!