Inspection on 05/09/05 for Norwood 60 Carlton Avenue

This inspection was carried out on 5th September 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 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

Norwood 60 Carlton Avenue 27/09/07

Norwood 60 Carlton Avenue 27/09/06

Norwood 60 Carlton Avenue 03/01/06

Norwood 60 Carlton Avenue 25/01/05

Norwood 60 Carlton Avenue 13/07/04

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 09/07/2008.

CARE HOME ADULTS 18-65 60 Carlton Avenue 60 Carlton Avenue Kenton Middlesex HA3 8AY Lead Inspector Sue Mitchell Unannounced 5 September 2005 9.40am 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. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 60 Carlton Avenue Address 60 Carlton Avenue Kenton Middlesex HA3 8AY 020 8907 0239 020 8907 3711 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) Norwood Amy Vickers Care Home 8 Category(ies) of LD, 9 registration, with number of places 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Younger adults aged 18-65 of both sexes Date of last inspection 25/1/05 Brief Description of the Service: 60 Carlton Avenue is a care home providing personal care and accommodation for up to 8 adults with learning disabilities. The care home is owned by Norwood, which is a Jewish organisation that provides care for children and adults with learning disabilities.The home is located in a residential street in Kenton, close to Harrow. The home is situatated very close to a park. There are local shops, a large supermarket, pubs, a post office, building societies and other amenities within a few minutes walk from the home. The home was opened in 1997, and consists of a purpose built detached building. There is a small garden area, and parking for 2-3 vehicles at the front of the house. The home includes a flat attached to the main house, where accommodation and support is provided for up to two service users, to enable them to have the opportunity to develop independent living skills. All the home’s bedrooms are single; one bedroom has a shower facility. The home has a passenger lift. There is an enclosed, accessible, well maintained garden at the rear of the property 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out during the morning until after lunch (5 hours duration). The residents living in the main house all have home based day care and were at home when the inspector arrived. Two residents who live in a supported flat attached to the home had already left to go to their day centres. One had gone on a trip to Brighton. The residents in the main house have limited verbal communication skills and use signs, gestures, sounds and physical contact to make their needs known. Staff were observed to speak clearly and caringly to the residents who were able to respond to any requests in their own way to show they understood. The residents were engaged in inhouse activities before going out to a trampolining session. Two remained behind with staff and went out for a walk in the local park. There were five staff on duty plus one person who was shadowing senior staff. The manager came in at 12 pm. All staff were helpful and informative during the inspection process. The inspection focussed on reviewing the last inspection requirements, new admissions, care plans, residents activities, staffing, training and health and safety matters. A tour of the premises was also carried out. What the service does well: What has improved since the last inspection? The home had met all the requirements from the last inspection, which is commendable. They are still waiting for the work to be done to convert the spare bedroom and bathroom into a sensory room and lounge. The manager is to write risk assessments when the work is scheduled to start. The organisation is now recruiting and training its own bank staff to provide support to homes that have vacancies. Residents continue to be reviewed regularly and their care plans updated. There is evidence that the staff listen’ to the resident’s requests for changes to their day care and other activities. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 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 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 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) 2 Prospective residents needs are assessed prior to admission to ensure that the home can meet their needs and wishes EVIDENCE: There had been one new admission to the home since the last inspection. This person moved into the flat adjacent to the main house. The information on this person was detailed. A comprehensive care plan had been written following his admission and first review with the placing authority. This person lives with another person in the flat. They have dedicated staff support to carry out their activities of daily living. These were detailed in the resident’s personal profile and care plan. Risk assessments were in place for each activity of daily living. The home reviews the care plan on a monthly basis with the residents in the flat. There was evidence that this had been carried out and the resident had signed the document. The inspector was unable to met with this resident on this occasion to discuss the move into the home. However the manager and staff stated that this person had made several planned visits before moving in. The resident had also been offered the opportunity to try out alternative activities within the home and in the community since his admission as he had expressed a wish to do this during the review. There had been changes to his day time activities, which had been chosen by him 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 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) 6,7,9 The residents’ care plans reflect their needs, choices and goals and how staff are to support them to achieve these goals. There are comprehensive risk assessments in place that support the residents’ choice of activity and lifestyle. Those residents who are able to discuss their daily living activities are supported to do so. EVIDENCE: Two care plans were sampled. One person is able to participate in discussion and make decisions and choices about their daily living activities. The care plans are comprehensive and cover all aspects of the residents life in and out of the home i.e. medical/health care, continence, mobility, communication, interests, socialisation social relationships, cultural needs, daily living and personal care needs etc. There is information on individual’s daily routines as well as risk assessments for each activity or task that is undertaken with the resident. The care plans are reviewed on a monthly basis with the resident as appropriate. There was evidence of reviews involving the placing authorities and any action to be followed up. The residents living in the main house are unable to participate in residents meetings due to their verbal communication difficulties. The two people in the flat have monthly “Flat Chats”. Records indicated that they discussed a range of topics with the staff such as holidays, 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 10 sharing with other people, chores, celebrations of festivals and birthdays and, planning activities and outings. They also plan their weekly menu and shop together once a week. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,17 The residents are supported to participate in a range of social and community activities within and out of the home on a regular basis. The residents’ Jewish culture is respected by staff in relation to their dietary and spiritual needs. Relatives are welcome in the home and residents are supported to keep in contact with their families. EVIDENCE: The home benefits from having an activities organiser within the organisation who organises new activities for residents to try within the community and liaises with other day care services. The residents individual activity programmes are on display and indicated a wide range of activities enjoyed by the residents such as trampolining, aromatherapy, sing songs, arts and crafts, bowling, attending a gardening project, music, foot spas, beauty treatments etc. A swimming trip is now being planned for some of the residents. The inspector was informed that the newest resident had expressed a wish to reduce his attendance at the day centre so he could join in with the other residents in some of the activities listed above. This had now been put in place. A number of activities take place within the local community and the home has its own transport. Five residents attend a play ground for adults 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 12 with learning and physical disabilities near Maidstone. Staff are currently looking for a nearer resource. Four residents are to go to see Mamma Mia in London soon. Norwood hires a hall each week so that the residents from other homes in the area can meet socially for a singing and dancing session. The inspector was informed that three residents had been to Spain with staff in August. Four are due to go to a holiday resort in Deal the following week. The remaining person does not like to travel far and so short day outings are planned for this person. All but one of the residents is Jewish. The organisation provides ongoing training for non Jewish staff on the Jewish Way of Life. The home celebrates all Jewish festivals and Shabbat is held each Friday. A volunteer comes in to assist with prayers and the meal with the residents. The home serves only Kosher meals. The non Jewish resident eats the same meals as the other residents. The inspector was informed that this had been discussed with the resident’s family prior to admission and there were no issues regarding this. The weekly menu was on display. Staff prepare the meals and food is ordered from Kosher suppliers. Residents all eat together with staff supporting them as appropriate. The lunchtime meal was seen to be potato latkes, frankfurters and salad, with fresh fruit for dessert. One person had chosen to have an alternative meal. The inspector was informed that all but one resident had family contact. The home is able to take residents to visit their family if the family is unable to travel. The home is in the process of having checks carried out on one of the volunteers who comes to the home on Fridays to be a befriender to one of the residents. The manager said that they were looking for a befriender or advocate for the person who has no family contact. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 The residents’ physical and health care needs are supported through regular health care checks using community facilities as much as possible. The home’s robust medication policy and procedure ensures that the residents are protected from harm EVIDENCE: The care files sampled gave details of all the individuals’ particular health care needs. There was a record of all appointments with relevant health care professionals. The residents have eye tests carried out in the home. The manager said that they were hoping to have a visiting dentist although the residents go to a local dentist at the moment. The residents are all registered with the same GP practice. Three people use the local chiropody service in the community. There are a number of residents who are epileptic and the home has regular input from the epilepsy nurse. One person has diabetes and is supported through regular checks by the diabetes nurse. There is support from the learning disabilities consultant and psychiatrist. The residents have regular blood tests at the surgery and have their medication reviewed on a regular basis by the GP. The medication cabinet was inspected and found to be in good order. All medication had been signed for the morning correctly. A record is kept of any medication that goes out with the residents and checked on return. The home has regular visits from the supplying pharmacist. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not assessed on this occasion 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,29 The residents live in a homely and comfortable environment, which is kept clean and tidy. One resident would benefit from the provision of a hoist to support them and staff in carrying out personal care tasks. EVIDENCE: The home has recently reduced its numbers to eight, having now only 6 people living in the main house and two in the flat. There are plans to provide a sensory room and small lounge in the vacant bedroom and spare bathroom. Funding has been agreed for this project. They are waiting for a date to start the work. The manager had been required at the last inspection to carry out risk assessments for when the work started. She stated that until she has a date and knows what work is being done she couldn’t do the risk assessments. She stated that they would be in place for when the work starts. New flooring is to be laid in the lounge and dining area. The newest resident has some visual impairment and the home had been assessed by the rehabilitation officer as to any equipment that might be needed to support this person when he moved into the flat. The lighting had been changed in the kitchen and bathroom following this visit. Another person uses a wheel chair. This person has been in the home since October 2004 and had had a moving and handling assessment in November 2004. The manager 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 16 stated that the recommendations from this assessment had not been actioned by Social Services to date. The manager had last contacted social Services in July 2005 to see if there was any progress. The resident requires a mobile hoist. Staff are currently moving and handling him without the aid of a hoist. Risk assessments are in place. The manager must pursue this issue with social services as a matter of some urgency in view of the length of time since the assessment. Both the staff and the resident are at risk should this situation continue. It is recommended that the manager contact the occupational therapist for a further moving and handling assessment. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The residents are supported by a stable, competent and well trained staff team. EVIDENCE: There are no vacancies in the staff team at present. One person is due to leave and another was going on maternity leave. The manager stated that there were staff appointed who were to cover both posts. Staffing levels were observed to be high on the day of the inspection with five staff plus an observer on duty. The manager also works some shifts to observe staff and work with the residents and was working a late shift on the day of the inspection. The manager informed the inspector that Norwood is operating a “cluster” scheme for staff that have previously worked in Israel and who are being trained and supervised to be bank staff for the Norwood homes. One person on the scheme was shadowing the senior staff and observing the staff working with the residents as part of her training. She stated that she had been to other Norwood homes and was having training and also was going to be doing NVQ3. She said that she found the work interesting and had had some experience in care work in Israel. Staff have undertaken a range of training since the last inspection medication; POVA, first aid, Jewish festival training. The manager stated that training is linked to TOPPS. The training department send information on staff training by e-mail to the home’s managers. The majority of training is run in house but external trainers are 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 18 purchased as required. Two staff are due to attend Person Centred Planning training run by Brent Council. Norwood runs its own POVA training, which is also included in the induction. NVQ 2 and 3 are in progress for most staff. The deputy is finishing her NVQ Level 3 in Care and hopes to register and progress to NVQ Level 4. The manager has now completed the Registered Managers Award and an NVQ Level 4 in Care. They are both NVQ assessors. Staff confirmed that they had had a range of training provided by the organisation. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 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 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 residents are protected by the homes robust health and safety policies and procedures and regular checks of the premises and equipment. EVIDENCE: All certificates relating to the appliances and equipment used in the home were made available for inspection. These were found to be up to date with no outstanding works required. Regular checks of the building are carried out. Premises and fire risk assessments were in place. There was a record of the weekly call bell tests. There was a record of recent health and safety training for all staff. 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 20 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score x x 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 3 x x x x 2 x 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 x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 60 Carlton Avenue Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 21 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 29 Regulation 13(4)(c )(5) 23(2)(n) Requirement The manager must pursue the purchase of a mobile hoist with social services as a matter of some urgency Timescale for action 30.9.05 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 29 Good Practice Recommendations It is recommended that the manager contact the occupational therapist for a further moving and handling assessment for the residnt who requires a mobile hoist 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 60 Carlton Avenue G62-G11 S17520 60 Carlton Ave v217533 70905 Stage 4.doc Version 1.40 Page 23 - 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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