Inspection on 08/09/05 for Martindale Road, 329

This inspection was carried out on 8th September 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Martindale Road, 329 02/07/07

Martindale Road, 329 15/12/06

Martindale Road, 329 30/05/06

Martindale Road, 329 31/01/06

Martindale Road, 329 15/11/04

Martindale Road, 329 14/07/04

Martindale Road, 329 05/02/04

Martindale Road, 329 05/08/03

Martindale Road, 329 21/07/03

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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 18-65 329, Martindale Road, Hounslow Middlesex TW4 7HG Lead Inspector Robert Bond Unannounced 8th September 2005 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. 329, Martindale Road, Version 1.10 Page 3 SERVICE INFORMATION Name of service Martindale Road, 329 Address Hounslow, Middlesex TW4 7HG 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) 0208 577 6031 Life Opportunities Trust Nicholas Horton Care Home 7 Category(ies) of Physical Disability (0), Learning Disability (0), registration, with number Learning Disability - over 65 years of age (0) of places 329, Martindale Road, Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2004 Brief Description of the Service: 329 Martindale Road, Hounslow is a purpose built seven place care home for adults with learning disabilities. Although a two storey property, the service users are all accommodated on the ground floor. Only the office is upstairs. Communal rooms are of a good size and there is a large and secure garden to the rear. All downstairs areas have level access and are accessible to people in wheelchairs. The locality is a residential area near a bus route to Hounslow town centre. 329, Martindale Road, Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector arrived at 10 am and left about 3pm. The Registered Manager was not present and so the Inspector was shown around all parts of the home by a Senior Support Worker. The Inspector met all other staff on duty and all the service users. The home was fully occupied by service users. There was one staff vacancy. The Inspector examined in detail the care records of one service user, and observed the service users having lunch. An inspector from Hounslow Borough Council’s Environment Health Department was present by coincidence at the same time. The CSCI Inspector inspected the home against 22 of the National Minimum Standards (NMS) for Care Homes for Younger Adults. Of these, the Inspector determined that 12 were fully met, 4 were partly met, and 6 were not met. The Inspector made 11 requirements and 1 recommendation. What the service does well: What has improved since the last inspection? The Senior Support Worker reported that the kitchen is clean, new carpets have been provided in service users’ bedrooms, the garden shed has been tidied, and trees in the garden have been cut back. 329, Martindale Road, Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 329, Martindale Road, Version 1.10 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 329, Martindale Road, Version 1.10 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) 2 and 5 The outcome for Standard 2 was not met for the reasons stated below (Requirements 1 and 2) The outcome for Standard 5 was fully met. EVIDENCE: NMS2: All the service users have been in the home since it opened in 1996, hence their original assessments date from then. The Inspector examined in detail (case-tracked) the records for one service user. He found that her ‘priority needs’ had been identified more recently but only in so far as activities and holidays were concerned, and no ‘target dates for action’ were shown. The file had a ‘health action plan’ but no assessment of personal care needs could be found. A ‘handling assessment’ and a risk assessment had been done in August 2003 but had never been update or reviewed. The last review by the placing authority (Hounslow Borough Council) was dated June 2003. No internal reviews had been done; the Regulations require the home to keep the assessment of service user needs under regular review. NMS5: A tenancy agreement was seen, together with a record that its contents had been explained to the service user, whose agreement to it had been witnessed in writing. 329, Martindale Road, Version 1.10 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. The outcome for Standard 6 is not met for the reasons given below. (Requirement 2). The outcomes for Standards 7 and 9 are met. EVIDENCE: NMS6: As described above, the service user plan seen by the Inspector was not adequate as it did not refer to personal care needs and how to meet them. It was reported by the senior support worker that ‘person centred plans had just been started.’ Although keyworkers are used in the home, the one who had worked on the service user plan the Inspector examined had not been named. NMS7: As most service users in the home are non-verbal, pictorial means are used to consult with them about food choices. Service User meetings are held monthly. NMS9: Risk assessments were seen on file, service users are taken out but cannot go out independently. 329, Martindale Road, Version 1.10 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, 14, 15, 16, and 17 The outcomes Standards 12, 13, 15, 16 and 17 were fully met. The outcome for Standard 14 is not fully met due to the state of the Snoozlen room. (Requirement 8) EVIDENCE: There was evidence of a birthday party having recently taken place. At least one relative visits on a regular basis. One service user goes to church weekly and church members visit him. An activity chart was` seen by the Inspector and the Senior Support Worker identified the following activities: cookery, swimming, walks and outings. The Inspector noted that the Snoozlen room contained a lot of things not related to activities available in that room, such as a hoist and battery charging equipment. As these are not conducive to activities, they must be stored elsewhere. Services users are encouraged to help set the table and take their dirty clothes to the laundry. The Inspector observed the service users eating spaghetti bolognaise. 329, Martindale Road, Version 1.10 Page 11 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 The outcomes for Standards 18 and 20 are not met for the reasons stated below. (Requirements 3, 4 and 5) The outcome for Standard 19 is met. EVIDENCE: NMS18: As indicated above, the service user plan seen by the Inspector did not refer to personal care needs and how the service user liked them to be met. NMS19: The care file examined contained a ‘health action plan’ and a weight chart that had been updated monthly. NMS20: No service user is able to control their own medication. The care file examined contained a ‘medication record sheet, but it was incorrect and was undated. The Inspector examined the MAR sheets and found that no entries had been made for 8am and 10pm on 7th September, or for 8am on 8th September 2005. The Inspector also examined the medication stored in blister packs and found that the pharmacist had issued these with the day sequence starting on the wrong day. This had confused the staff in the home who had extracted tablets from the incorrect blister in many cases. Because of the 329, Martindale Road, Version 1.10 Page 12 potential danger this posed to service users of mis-administration of medication, the Inspector issued an Immediate Requirement to get the medication re-packaged. The records of medication returned to the pharmacist must be improved as the pharmacist is not currently always signing for the medication they receive. 329, Martindale Road, Version 1.10 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 The outcomes of both Standards are not fully met for the reasons stated below. (Requirements 6 and 7). EVIDENCE: NMS22: The Inspector examined the home’s complaints record. This was not adequate as for example, concerning the complaint made on 14th September 2004, there were not full details of the complaint, the investigation undertaken, and the outcome. NMS23: Staff have been trained in Adult Protection, however the home’s adult protection policy and procedure (as issued by Life Opportunities Trust) does not refer to the role of either the CSCI or the local Council’s Adult protection Team. 329, Martindale Road, Version 1.10 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 and 30 The outcome to Standard 24 is not met for the reasons stated below. (Recommendation 1 and Requirements 9 and 10). The outcome to Standard 30 is only partly met pending the kitchen refurbishment. (Requirement 11) EVIDENCE: The corridor on which the service users have their bedrooms contains a large number of unmarked doors, giving access to bedrooms, bathrooms, toilets and store cupboards. The Inspector found this area to be very bland and confusing and recommends that doors are marked to show the purpose of the room behind. This could be in writing, in pictorial symbols, by colour coding or even all three. The Inspector was very concerned about the incidence of Health and Safety risks he identified. These were newspaper stored in a cupboard at the foot of the staircase, the laundry room being unlocked despite it containing cleaning chemicals, more cleaning chemicals in an unlocked cupboard in the kitchen, turpentine left in the back garden, and the unlocked garden shed also 329, Martindale Road, Version 1.10 Page 15 containing materials marked as being ‘hazardous to health’. Staff must be trained in the Control of Substances Hazardous to Health Regulations. Although the home was found to be clean and hygienic overall, the worn kitchen floor is a concern. 329, Martindale Road, Version 1.10 Page 16 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) 35 and 36 The outcomes to Standards 35 and 36 are fully met. EVIDENCE: The Inspector examined the home’s staff rota the current week. Sufficient staff were rostered to be present; that is three support workers during the day and two support workers at night. Training records were also examined. The Senior Support Worker reported that 6 staff out of 15 were undertaking NVQ’s in care. An example of a staff supervision record was also seen. 329, Martindale Road, Version 1.10 Page 17 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) 39 and 42 The outcome of Standard 39 is fully met. The outcome for Standard 42 is not met due to the Health and Safety concerns identified above. EVIDENCE: Service user views are obtained at care reviews, in service user meetings (minutes seen), and by the use of questionnaires. Fridge and freezer temperature records were checked, the hot water temperature was checked, and fire drill records were examined. 329, Martindale Road, Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 1 x x 3 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 2 Standard No 11 12 13 14 15 329, Martindale Road, x 3 3 2 3 Standard No 31 32 33 34 35 36 Score x x x x 3 3 Version 1.10 Page 19 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 1 3 1 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 1 x 329, Martindale Road, Version 1.10 Page 20 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 2 Regulation 14 (2) Requirement The registered person shall ensure that the assessment of the service users needs is kept under review and revised at any time it is necessary to do so having regard to any change of circumstances. The Service user plan must show how the service users needs in respect of health and welfare are to be met, and the registered person must keep the plan under review. All administration of medication must be recorded and initialled at the time of adminstration Blister pack medication should not be accepted from the pharmacist if it is incorrected labelled or packaged The records for medication returned to the pharmacist must show that the pharnacist has signed for receipt of the medication. The registered person shall establish a procedure for investigating complaints that meets the Standard required The registered person shall prevent service users being Version 1.10 Timescale for action 011105 2. 6 15 011105 3. 4. 20 20 13 (2) 13 (2) 011005 011005 5. 20 13 (2) 011005 6. 22 22 011205 7. 23 13 (6) 011205 329, Martindale Road, Page 21 8. 14 23 (2) (l) 9. 24 and 42 13 (4) 10. 24 and 42 13 (6) 11. 30 23 (2) (b) harmed or suffering abuse (by having in place adequate policies and procedures that meet the Standard required). The registered person must make suitable provision for storage for the purposes of the care home. The registered person shall ensure that all parts of the home to which service users have access are free from hazards to their safety. The registered person shall train staff to prevent service usersfrom being placed at risk of harm (COSHH regulations) The kitchen floor must be replaced 011105 011005 011105 011205 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 24 Good Practice Recommendations That ways are considered for brightening up the corridor outside service user bedrooms, and that doors are labelled in some way. 329, Martindale Road, Version 1.10 Page 22 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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