Inspection on 24/08/05 for Lowdell Close, 186-188

This inspection was carried out on 24th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lowdell Close, 186-188 14/12/06

Lowdell Close, 186-188 29/06/06

Lowdell Close, 186-188 04/02/06

Lowdell Close, 186-188 17/11/04

Lowdell Close, 186-188 22/07/04

Lowdell Close, 186-188 14/10/03

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Chatsworth Care - Tudor Lodge

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Lowdell Close, 186-188 Yiewsley West Drayton Middlesex UB7 8RA Lead Inspector Ged Durkin Unannounced 24 August 2005 4:15pm The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lowdell Close, 186-188 Address Yiewsley West Drayton Middlesex UB7 8RA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01895 434697 Life Opportunities Trust Mrs Louise Anne Rees CRH Care Home 4 Learning disability 4 Category(ies) of LD registration, with number of places Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17/11/04 Brief Description of the Service: This is a home for four adults with learning and physical disabilities. Two have profound disabilities. Although the home is not purpose built it has all the aids and adaptations the service users need. It is on two floors and there is a lift. All the bedrooms are single rooms and they are an adequate size for wheel chair users. The home is owned by Ealing Family Housing Association and managed by Life Opportunities Trust. It is on a housing estate and is a long walk to shops and other local amenities. There is a minibus for taking service users out of the home. There is a Sensory Room for the provision of stimulation to the service users. Activities are provided in house and outings are arranged. Two service users are taken to a weekly club for people with learning disabilities. The service users socialise with service users who live in homes managed by Life Opportunities Trust nearby. There were no vacancies on the day of inspection. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out between 4:15pm and 6:35pm. The service users had all just returned from day services and staff on duty were busy with seeing to their care needs and preparing supper. All the service users have profound disabilities and the majority are unable to verbally communicate. The Inspector spoke with both staff members on duty, examined documentation and had a tour of the house. Staff on duty were unable to tell the Inspector the extent to which the previous requirements from the last inspection had been met. In the absence of of the Registered Manager, who was sick, the Inspector contacted the Responsible Individual who was able to update the Inspector. The Inspector was informed that progress is now being made towards meeting one long standing requirement regarding the home’s patio. What the service does well: 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. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2 LOT have not completed updating the home’s Statement of Purpose and Service User’s Guide but the home operates a full assessment process. EVIDENCE: The Inspector was informed by the Responsible Individual that the Statement of Purpose and Service User Guide are still in process of being updated but would soon be completed. The home has a settled and long standing service user group, with no admissions since 1996. LOT has a pre-admission assessment document which the Inspector viewed for two of the service users in their care plans. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 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 standard(s) 6, 7 and 9 Service users have detailed individual care plans that are reviewed. The home tries to facilitate service users to make decisions about their day to day living and encourage them to take appropriate risks in independent living. EVIDENCE: The Inspector viewed two care plans that included sections on personal information, assessment, health care, social events record, reviews, correspondence and finance. The documentation seen was detailed and thorough. Both plans of care had been subject to recent reviews. The home has regular service user meetings that offer service users the opportunity to be informed about events or activities. Risk assessments were seen for activities such as use of wheelchairs and transporting service users in the community. All risk assessments seen were current and up to date. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 and 17 The service users have profound disabilities but do take part in regular activities away from the home and are offered opportunities within the home to participate in limited interests that their disabilities allow them to. The service users have on going relationships with family and the home provide healthy attractive meals in a comfortable setting. EVIDENCE: All the service users attend day centres through out the week and go on outings on a regular basis. Staff informed the Inspector that service users enjoy watching television and listening to music and staff also read to service users, if they wish. All the service users have ongoing contact with their family and one service user stays with his/her family at weekends. The Inspector was able to observe suppertime in the home. The meal served to the service users was attractive and looked tasty. Two service users ate unaided while the other two service users required staff to assist, which was done in a sensitive manner. The meal was prepared according to the digestive abilities of the Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 11 service users. There was plenty of food stored in the kitchen with a lot of fresh fruit and vegetables in evidence. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. Service users receive all appropriate care and support in meeting their needs. The home operates a safe system of administrating medication. EVIDENCE: All the service users receive personal care and support as outlined by each individual care plan. All the service users looked well cared for and appropriately groomed. The service users health care needs are met through access by community based services such as district nurses, opticians and dentists. Service users are able to access specialist services such as neurologists and occupational health therapists as required. None of the service users self medicate and the home uses a monitored dosage system. The Inspector examined the medication administration sheets for the current month and all was in order with no gaps. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Staff have good relationships with service users and are able to communicate with them to meet their wishes. The home’s adult protection policies need to be updated in conjunction the Hillingdon Multi-Agency Adult Protection documentation. EVIDENCE: The Inspector observed staff being able to communicate with service users as they went about their duties. Although the service users have very limited verbal communication skills, staff have a good knowledge of the service users to enable them to communicate with each other. The home has its own adult protection policy, dated May 2003, together with a previous Hillingdon local authority adult protection policy. The Responsible Individual informed the Inspector that Hillingdon had provided training for home’s managers and that the current policy would be updated according to Hillingdon’s latest adult protection policy. An examination of staff training records demonstrated that care staff have also received recent training on adult protection. One staff member, when spoken with by the Inspector, was not aware of the term “Whistle blowing” but was able to tell the Inspector what she would do in the event of coming across any type of abuse towards the service users. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27, 28, 29 and 30 The environment is well suited to communal living and meets the needs of the service users with the necessary adaptations. There are some signs of wear and tear around the home that need to be addressed. The issue of the patio is still outstanding. EVIDENCE: The home has all the necessary adaptations to meet the needs of the service users. There are ceiling hoists, ramps, adapted toilets and bathrooms and a lift. The Inspector looked into a couple of service user rooms and both were furnished and decorated according to individual tastes. The home was generally clean, tidy and homely in appearance. There were parts of the home that looked worn where wheelchairs had knocked against walls and doorframes particularly in the downstairs corridor and door frames to the kitchen and lounge area. The Responsible Individual informed the Inspector that the issue of the patio was being resolved. A meeting with the housing association and architects due to take place shortly in order to finally resolve this long standing requirement. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 35 Service users receive all necessary support from sufficient numbers of staff who have access to appropriate training. EVIDENCE: Staff told the Inspector that there are always two staff on duty throughout the day and night to meet the needs of these highly dependent service users. The Inspector confirmed this by examining the staff rota. There are some current staffing shortfalls because of staff sickness and a recent resignation, but the home are able to utilise bank staff and are recruiting to fill this vacancy. The Inspector examined staff training records, which included training on adult protection, moving and handling, first aid and fire training. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The home ensures that so far as is practicable the health, safety and welfare of service users. EVIDENCE: The Inspector examined a number of health and safety records that included monthly recording of water temperatures, servicing and testing of fire protection equipment, work place risk assessments, moving and handling assessments and the home’s infection control policy. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lowdell Close, 186-188 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 18 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 1 Regulation 4&5 Requirement Timescale for action 14/11/05 2. 23 13 (6) 3. 4. 24 24 23 (2) (b) 13 (4) (a) The Statement of Purpose and Service Users Guide must be updated. Copies must then be forwarded to the CSCI. (Previous timescale of 17/1/05 not met) The homes policies and 14/11/05 procedures for the Protection of Vulnerable Adults must be updated in conjunction with no secrets and dovetail with the Hillingdon Multi-Agency Adult Protection documentation. (Previous timescale of 17/1/05 not met) Wear and tear to the structure of 21/11/05 the home caused by wheel chairs must be remedied. An Action Plan regarding the 5/12/05 extention of the patio must be forwarded to the CSCI. This is restated from the last inspection. The Action Plan must include a timescale for completion not to exceed 5/12/05. (Previous timescale of 1/1/05 not met) 5. Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Lowdell Close, 186-188 G61-G10 s27064 Una-Lowdell Close v239495 240805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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