Inspection on 27/10/08 for Milbury 7 Kinch Grove

This inspection was carried out on 27th October 2008.

CSCI found this care home to be providing an Good service.

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

Milbury 7 Kinch Grove 03/11/06

Milbury 7 Kinch Grove 16/12/05

Milbury 7 Kinch Grove 06/05/05

Milbury 7 Kinch Grove 07/03/05

Milbury 7 Kinch Grove 26/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Milbury 7 Kinch Grove 7 Kinch Grove Wembley Middlesex HA9 9TF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Daniel Lim     Date: 2 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Milbury 7 Kinch Grove 7 Kinch Grove Wembley Middlesex HA9 9TF 02089040084 F/P02089040084 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Milbury Care Services Ltd Name of registered manager (if applicable) Ms Barbara Bedward Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 7 Kinch Grove is a care home registered to provide personal care and accommodation for adults with learning difficulties. It is run by Milbury Care Services Limited, an organisation which has homes in other parts of the country. The home is a semidetached house situated in a quiet residential cul-de-sac. It is close to Kingsbury Road for shops and public transport. There is parking on the road outside and a paved area at the front of the home for up to two cars. The property has a large garden to the rear. There are three bedrooms for service users on the first floor and one on the ground floor. There are four residents living in the home. There is a supported living Care Homes for Adults (18-65 years) Page 4 of 28 care home 4 Over 65 0 4 Brief description of the care home scheme at Daltry House and Geneva Court, which the Manager and Deputy have been overseeing since 1 January 2005. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was carried out on 27 October 2008 and took a total of six hours to complete. We were assisted by the registered manager, Ms Barbara Bedward. Two residents were interviewed. Although some communication difficulties were experienced the general impression gained was that they were well cared for. Statutory records were examined. These included three residents case records, the maintenance records, accident and incident records, financial records, complaints Care Homes for Adults (18-65 years) Page 6 of 28 records and fire records of the home. The premises including residents bedrooms, communal bathrooms, laundry, kitchen, garden and communal areas were inspected. Two care staff were interviewed regarding the care of residents and other areas associated with their work. They were noted to be knowledgeable regarding their roles and responsibilities. One completed staff survey indicated that the staff concerned was happy with the management of the home. Staff records, including evidence of CRB disclosures, references, supervision and training records were examined. In addition, the minutes of residents and staff meetings were examined. These indicated that residents and staff had been consulted and informed of changes affecting the running of the home. The completed Annual Quality Assurance Assessment form (AQAA) was received by CSCI. Information provided in the assessment was used for this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken by the manager. Admissions only take place if the service is confident that the needs of people to be admitted can be met. This ensures that the admissions to the home are appropriate. Evidence: The preadmission assessments which were examined were noted to be appropriate and comprehensive. The assessments included details of the personal, mental, cultural and spiritual needs of residents. Risk assessments had also been prepared for residents admitted to the home. The completed AQAA of the home stated that all prospective residents are assessed by the management team to ensure that the home can meet the needs of individuals before their admission. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Residents in the home were noted to be well cared for. They were clean and appropriately dressed. No new residents had been admitted since the last inspection of the home. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are committed to supporting service users lead purposeful and fulfilling lives. A variety of methods are used to help service users contribute in the development of their care plans. The care plans include appropriate risk assessments. Residents are consulted on how the service runs and activities they wish to participate. Evidence: The three residents case records contained comprehensive and appropriate care plans, assessments and details of reviews carried out. The preferences of residents had been documented. There was documented evidence that residents had been encouraged to be as independent as possible. Risks assessments had been prepared for residents. They were noted to be comprehensive and up to date. Staff were aware of action to be taken to minimise risk. The case records of a resident who was at risk of getting lost when he goes out were examined. It contained appropriate guidance to staff to provide close supervision for this resident on journeys. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: There was documented evidence that the care of residents had been reviewed. The minutes of these reviews (including reviews done by health and social services professionals) were kept in the case records and available for inspection. The AQAA stated that care plans are drawn up with the involvment of residents and their representatives and residents are enabled and supported to make decisions in all areas of their lives. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had sought the views of residents and considered their varied interests when planning their daily routines. Links to specialist support are facilitated when needed. Residents have the opportunity to develop skills and are encouraged to be as independent as possible. The meals arrangements take into account the preferences of residents and their dietary needs. Evidence: The home had an activities programme for each resident. These were kept in the files of the resident concerned and was available for inspection. Staff use a pictorial representation of the various activities. These included swimming, gymnasium, cooking, grooming, gardening and attendances at lifeskills courses. Service users are supported in carrying out budgeting tasks whilst being accompanied shopping by a member of staff, and recordings of such monies spent are logged in expenditure Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: books. We were able to observe staff interacting with residents. Staff were attentive and supportive towards them. The bedrooms of residents contained ornaments and souvenirs which reflect individuals interests, cultural and religious beliefs. The manager stated that these had been redecorated to suit the preferences of residents. There was also documented evidence in the case records that residents had been visited by their family or had visited their relatives. The kitchen was inspected and found to be clean. Daily recorded temperatures of the fridge and freezer had been kept. These were satisfactory. A fire blanket and fire extinguisher were in place. The menu examined appeared balanced. During discussions regarding care of residents from various backgrounds, the two staff and the manager demonstrated a good understanding of the various cultures and religions. The homes AQAA indicated that it is able to provide meals that cater for the cultural and religious requirements of residents. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory arrangements for personal and specialist healthcare requirements were in place. Personal support provided was responsive to the individual needs and preferences of people who use the service. Residents individual plans clearly record their personal and healthcare needs and how they will be delivered. The service was sensitive to the changing needs of residents. Staff are well trained and competent. Evidence: The three residents in the home appeared well cared for well. They indicated that they were happy in the home. Three residents case records examined contained details of how the healthcare needs of residents had been met and included appointments with the doctor, optician, dentist and chiropodist. The individual preferences of service residents had been documented and staff were aware of them. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The medication charts were examined. These indicated that medication had been administered as prescribed. These were satisfactory. The home had a policy and procedure for the administration of medication. The temperature records of the fridge and room where medication was stored had been recorded. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for responding to complaints and for adult protection were satisfactory. The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. This ensures that residents are well treated and protected from abuse. Residents and others involved with the service say they are happy with the service provision. Evidence: The complaints record was examined. No complaints were recorded. The manager explained that none had been received. The manager and her staff were aware of the procedure to follow when responding to allegations of abuse. There was documented evidence that staff had been provided with adult protection training and when interviewed, they were aware of the procedures to follow when responding to allegations or incidents of abuse. The issue of equalities and diversity was discussed with the manager and her staff. They were aware of the importance of treating all residents sensitively and with respect regardless of disability, gender, race, religion or sexual orientation. The home had an equalities and diversity policy. No allegations of abuse had been brought to the attention of the CSCI. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: A record of compliments received by the home had been kept. These indicated that relatives were satisfied with the care provided. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The premises were clean, homely, comfortable and cheerfully decorated. People who use the service can personalise their bedrooms. Evidence: Bedrooms inspected had been personalised by residents with their own pictures and ornaments. The homes AQAA stated that residents are encouraged to bring in their own furnishings and memorabilia and arrange these according to their preferences. In addition, the manager stated that residents could choose the colour scheme for their bedrooms. The communal areas inspected were clean, tidy, and well furnished. The gardens were attractive and seating had been provided. No offensive odours were detected. The laundry room was inspected and noted to be well equipped. The manager was aware if the need to wash soiled linen in special sluice cycle to prevent cross infection. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The required safety inspections had been carried out. The manager stated that no specialist equipment was required as all residents were independently mobile and did not require any specialist equipment. Following requirements made in the last inspection report, a new toilet had been installed and the bathroom was regrouted. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a good recruitment procedure that is followed in practice. The manager recognizes the importance of training and tries to deliver a programme that meets statutory requirements. Staff were found to be knowledgeable. Evidence: The duty rota was examined. It indicated that in addition to the manager, there was normally a minimum of two care staff on duty during the day shifts and two care staff on duty during the night shifts. There is a maintenance person who is shared with other homes run by the company. The manager is aware of the need to keep staffing numbers under review to ensure that the home can continue to meet the changing needs of the people living there. The night staffing arrangements were discussed. We have concerns that only one staff is on duty during the night to care for residents with high needs. To ensure the safety and security of residents, and to ensure that the needs of residents are fully met, a review of staffing during the night shift is required. Two staff who were on duty were interviewed on a range of topics associated with their Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: work. They were noted to be knowledgeable regarding their roles and responsibilities. There was documented evidence in staff records to indicate that staff had been provided with essential training relevant to their area of work. Staff stated that there is a good team spirit and they worked well together. The records of two staff were examined. These indicated that the required recruitment standards and procedures such as obtaining satisfactory CRB disclosures and references had been followed. There was documented evidence of regular formal staff supervision. This was also confirmed by staff interviewed. The supervision notes indicated that staff had opportunity to discuss any work related problems, issues related to the care of residents and their training. The issue of equalities and diversity was discussed with the manager and her staff. Staff demonstrated an understanding of the need to treat all residents sensitively and with respect regardless of disability, gender, race, religion or sexual orientation. They were aware that they must not discriminate against residents. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was run in the best interest of residents and satisfactory arrangements were in place to ensure the safety and welfare of residents in the home. The manager has a clear understanding of the key principles and focus of the service. She works continuously to improve services and provide an increased quality of life for residents. Evidence: The manager was knowledgeable regarding the management of the home. She stated that she had received her NVQ L4 and RMA qualifications. All staff interviewed were satisfied with the management of the home. The home has effective quality assurance and monitoring systems. This included a development plan and consultation with residents regarding the management of the home. The minutes of residents meeting were available for inspection. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The manager stated that the home had maintained good relationships with the local community and there had been no complaints from local residents. A current certificate of insurance was available for inspection. The financial record of three residents were examined. The records were well maintained and contained receipts for items purchased on behalf of residents. The fire logbook was examined. The weekly fire alarm tests, fire drills and fire training had been carried out and documented. Up to date fire risk assessments had been carried out. The emergency lighting had been checked regularly. The required health and safety inspections on the portable appliances, gas and electrical installations had been carried out. A window restrictor in one of the bedrooms on the first floor was not engaged. This was brought to the attention of the manager who promptly made arrangements with the maintenance person for this to be rectified. We noted that the fence at the end of the garden was damaged. This must be repaired to ensure the safety and security of residents. This was discussed with the manager who agreed that this would be done. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 32 18 A review of staffing during the night shift is required. This is to ensure the safety and security of residents, and to ensure that the needs of residents are fully met. 01/04/2009 2 42 13 The fence at the end of the garden which is damaged must be repaired. This is to ensure the safety and security of residents. 01/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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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