Inspection on 13/07/07 for Money Lane, 1

This inspection was carried out on 13th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Money Lane, 1 29/01/07

Money Lane, 1 22/02/06

Money Lane, 1 14/07/05

Money Lane, 1 07/10/04

Money Lane, 1 25/06/04

Money Lane, 1 18/06/03

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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 Money Lane, 1 West Drayton Middlesex UB7 7NU Lead Inspector Ms Susan Woolnough-Singh Key Unannounced Inspection 13th July 2007 09:30 Money Lane, 1 DS0000027066.V341326.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 Money Lane, 1 DS0000027066.V341326.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. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Money Lane, 1 Address West Drayton Middlesex UB7 7NU 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) 01895 430 687 01895 439 522 h309@mencap.org.uk www.mencap.org.uk Royal Mencap Society Gail Andrea Varley Care Home 5 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user can continue to be accommodated over the age of 65 years old, as agreed by the Commission For Social Care Inspection on the 23rd November 2004, whilst the home can meet the needs of all service users. The home must advise the CSCI when the service user no longer resides at the home. 29th January 2007 Date of last inspection Brief Description of the Service: Money Lane is a care home registered to provide care for five adults with learning disabilities and mental health needs. The property is owned by New Era Housing Association and managed by MENCAP. The home is located in a quiet residential area of West Drayton close to local shops and transport links. The service users bedrooms are located on the ground and first floor and there are bathroom facilities on both floors. There is a lounge, kitchen and separate dining room on the ground floor and a small office/sleeping in room for staff on the first floor. There is a well maintained garden to the rear of the house. The range fees are £249 to £377. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Money Lane. The purpose of the Inspection was to assess the key standards for younger adults and to follow up the statutory requirements. Five requirements were made at the inspection on 29th January 2007 these had all been met. Two requirements applied to the care of a person who has now left for a more suitable placement. As required new floor covering has been purchased and fire safety bolts have been fitted to the bedroom doors of people who wish to prop these open. A Manager has been appointed and will be applying to become the Registered Manager with the Commission for Social Care Inspection. The Inspector spoke with three people who use the service and toured the building. Care plans, staff personnel files and health and safety records were examined. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 6 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 Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are assessed before moving into money Lane. This assessment focuses on ensuring that the facilities and care services provided meets people’s needs. EVIDENCE: One person has moved out of Money Lane since the last inspection. The home could no longer meet the needs of this person and he/she has moved onto more suitable accommodation. A person has been identified for this vacancy and had already had one overnight stay. A weekend stay was due to be arranged. MENCAP has a policy and procedure on the introduction of new people to their residential homes. The assessment completed by Hillingdon Community Team for People with Learning Disabilities was seen, all of the areas central to providing a care service had been assessed. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are in place to identify the areas of support needed. Staff are committed to involving people in the planning of their care and supporting their independence. EVIDENCE: The care plans of three people were examined. MENCAP has a care plan format, which is used to record all aspects of the care and support that people need. The care plan is written in the first person; therefore the person is stating the areas of care they need support with. A number of risk assessments were also seen. Risks of daily living had been identified, these related to community, household and personal safety. A new risks assessment format were due to be introduced; the new format is more person centred and it is hoped that people will be given the opportunity to become more independent. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 9 People spoken with indicated that they are supported to make their own decisions and are able to make choices on how to spend their time. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to make choices and develop their life skills. EVIDENCE: Each person who lives in the home has a weekly activity schedule the Inspector saw this. Some people attend a day service on a part time basis. Two people have direct payments so are able to make a choice twice a week where they would like to go during the day. One to one is used on these identified days to take people out. When people are at home during the week they are encouraged to make their lunch and be involved in basic housework tasks. People are encouraged to participate in the preparation of the evening meal. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 11 People at the home have regular contact with family and friends and spend short periods away from the home. One person had been on holiday with a family member. One person goes out to church on a Sunday morning . The Inspector spoke with three people who use the service. Two people had particular interests; these were reflected in theirs bedrooms. People confirmed that they did participate in the housework and doing their own laundry. People spoke about what they liked to do in their leisure time and confirmed that they liked the staff. People are involved in menu planning, and are encouraged to prepare their own breakfast and lunch, staff prepare the evening meal. The home keeps a detailed record of food served at meal times Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The home has policies, procedures and guidance for staff on the safe administration of medication. EVIDENCE: The personal care needs of people are recorded as part of the care plan; these are recorded in detail and give clear guidance on the level of support required. Two people who use the service have a Health Action Plan, the date on the health actions plans was 2004. It is recommended that these are reviewed and updated. A record is made of visits to and from health care professionals. A major pharmacy supply medication to the home in blister packs. The Pharmacy also regularly reviews the record keeping and storage of medication in the home. The last pharmacy inspection was carried out on 6th June 2007. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 13 A recommendation was made that prescribed creams, were dated when opened. The medication cabinet and medication administration records were seen and found to be in order. Each individual medication record has a photograph of the person and a description with side affects of the medication prescribed. All staff have received medication training. MENCAP policies and procedures are available for guidance on the safe handling of medication. People who use the service do not administer their own medication. There was reference in one persons care plans as to how staff were to support this persons bereavement, this is good practice. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is This judgement has been made using available evidence including a visit to this service. People are supported and safeguarded by complaints procedure and the training received by staff in the protection of vulnerable adults. EVIDENCE: A complaints procedure is available. This contains the information needed to make a complaint and contact details for MENCP Service Managers, CSCI and the Ombudsman. There is an audio version of the complaints procedure. The file for recording complaints was seen; there had been no complaints since the last inspection. People who use the service indicated that they were settled at Money Lane. All staff have completed training in the protection of vulnerable adults apart from one member of staff who is on maternity leave. Keeping vulnerable adults safe also features as part of the MENCAP induction training. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clean comfortable and homely environment is provided for people who love at Money Lane. People have bedrooms that suit their needs and reflect their interests. EVIDENCE: The home is comfortable and well maintained; there are two communal areas the lounge and dining room. A patio area can also be used. A requirement was made at the last inspection for the flooring to be replaced in the kitchen and the hall this had been done. The bedrooms of three people were viewed and these were seen to be personalised and comfortable, one person said/he she liked to spend a lot of time there, this being a preference. One person really liked music and had a good collection of this. One person was able to point out to the inspector that some items from the family home had been brought in. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 16 All part of the home were seen, including bathrooms and the kitchen. All of these areas were found to meet a high standard of cleanliness. As part of the plan for improvement some areas of the home had been identified for decoration and the purchase of the furniture. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team have the skills, knowledge and expertise to meet the needs of the people living at Money Lane. EVIDENCE: New staff receive a good induction programme provided by MENCAP. This completed as part of the new staff probationary period. The induction is completed in a workbook and includes the knowledge and skills required to work in residential care and support people who use the service. At the present time the number of staff who have completed an NVQ in care is low. Only one member of staff has completed NVQ training, further training opportunities in this area must be planned. The staff team consists of the Manager Designate, and four support workers. One staff vacancy has recently been filled. MENCAP relief workers are employed to cover vacant posts and shifts. There is a minimum of two members of staff on shift during waking hours. One member of staff sleeps on Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 18 the premises overnight. There is no waking night staff. Additional staff are employed to carry out one to one work with people who live. The personnel files of two members of staff were seen. One member of staff had been working at the home for a substantial number of years; one member of staff was new to the staff team. The required documentation was on file including identity verification, CRB checks and two written references. There was evidence in the files that staff had received regular one to one supervision. This had been recorded. It is to be recommended that the personnel files be tidied up, as information was not easy to access, as paperwork did not appear to be in any order. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home now has a Manager who will be able to give direction and consistency, which will lead to an improved service for people who love at Money Lane. EVIDENCE: The Manager Designate has experience in working with people with a learning disability; she has worked at Money Lane as the Deputy Manager and has a NVQ Level 3. The Inspector advised that an application be made to the CSCI Registration Team as soon as possible. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 20 Regular staff meetings are now taking place the previous minutes of these were seen. Regular items on the agenda are household issues and the care of people who use the service. Questionnaires had recently been sent out to people’s family/carers, these had not been returned at the time of the inspection. People who use the service were also due to be consulted with regard to their views. The Manager of another MENCAP home carries out this consultation. A continues improvement programme is in place, this identifies tasks needing to be done such as the renewal of furniture, redecoration, improvements in health and safety and care. The Manager Designate had completed the Annual Quality Assurance Assessment; the information in this gave a clear indication that the strengths and weaknesses of the home had been considered. People who use the service who wish to have their bedroom doors propped open are now able to do so safely, on the advice of the Fire Authority bedroom doors have been fitted with bolts that release when the fire alarm is in action. A monthly health and safety audit is carried out this includes electrical equipment and hot water monitoring and a check to ensure that the first aid box is fully equipped. Fire records indicated that regular fire alarm testing is taking place. The fire extinguishers had been inspected in July, the fire alarm system had been in May and Fire Drills had taken place over the last three months. The premises Fire Risk assessment was dated 7th May 2007. Staff training has taken place training in food hygiene, first aid, infection control, fire safety and health and safety. However, according to the training spreadsheet provided three staff had not completed training in infection control, moving and handling, first aid and health and safety. Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 3 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 3 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 2 x Money Lane, 1 DS0000027066.V341326.R01.S.doc Version 5.2 Page 22 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 YA32 Regulation 18 (1) (a) Requirement The Registered Provider must ensure that all staff are given the opportunity to progress their knowledge and skills to NVQ Level 2 or 3. The Registered Provider and the Registered Manager must ensure that all staff undertakes the full range of health and safety courses. Timescale for action 01/06/08 2 YA35 YA42 18 (1)(a) 01/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA19 Good Practice Recommendations Health Action Plans should be reviewed and brought up to date. 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