Inspection on 31/01/08 for Old Oak Road, 20

This inspection was carried out on 31st January 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Old Oak Road, 20 09/07/09

Old Oak Road, 20 20/08/08

Old Oak Road, 20 16/07/07

Old Oak Road, 20 04/05/06

Old Oak Road, 20 28/09/05

Old Oak Road, 20 06/01/05

Old Oak Road, 20 11/08/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Old Oak Road, 20 Old Oak Road 20 Old Oak Road Acton London W3 7HL Lead Inspector Jacqueline Derbyshire Key Unannounced Inspection 31st January 2008 09:00 Old Oak Road, 20 DS0000019140.V348576.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 Old Oak Road, 20 DS0000019140.V348576.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. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Oak Road, 20 Address Old Oak Road 20 Old Oak Road Acton London W3 7HL 020 8740 1296 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) info@yarrowhousing.org.uk Yarrow Housing Ms Martyne Rosaria O Reilly Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons for whom residential accommodation with both board and care is provided at any one time shall not exceed 6 people with learning The number of persons for whom residential accommodation with both board and care is provided at any one time shall not exceed 6 people with learning difficulties two of whom may have a physical disability 16th July 2007 Date of last inspection Brief Description of the Service: 20 Old Oak Road is a registered care home providing accommodation and personal care for six men and women with a learning disability. At the time of this inspection, one male and five women were living in the home. The home is located in a residential area of Acton and there are good transport links with the community facilities in Hammersmith and Shepherds Bush. Shepherd’s Bush Housing Association owns the property and the care is provided by Yarrow Housing Limited, a voluntary organisation. The home provides an adequate standard of accommodation. It was fully accessible to people with a physical disability and people with limited mobility, including those who use a wheelchair with lift access to the top floor. The weekly fee for Old Oak Road is £1042.37. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star, this means the people who use this service experience good quality outcomes. This unannounced inspection took place on Thursday 31st January 2008; the inspector spent 4.00 hours visiting the home. The Inspector spoke with two of the people living at the home, the Manager, and staff. The Inspector checked the care records of two residents; two of the residents finance records and all of the resident’s medication records. Four of the residents bedrooms were looked at and all communal parts of the home. The home provides an adequate standard of accommodation that was seen to be clean and tidy on the day of this inspection. 4 surveys that had been completed with the residents and their key workers that were returned to the CSCI, information from the surveys will be included in this report. All of the 8 requirements that were set July 2007 have been met; 1 new requirement has been set from this visit. The water temperatures in Old Oak Road continue to be a source of problems as the water is to cool in certain outlets. What the service does well: The Person Centred Planning (PCP) has improved immensely and all residents are now fully involved in the process. All Person Centred Planning (PCP) review meetings were up to date with relevant records in place to show the service users aims and aspirations. Passport books on individual service users are excellent with information telling their story of who they are what are their likes and dislikes. These books have photographs and picture details also. All of the documentation that was looked at by the Inspector was up to date. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 6 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. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. EVIDENCE: The Inspector looked at two residents files and each had a full assessment in place from the initial admission from the local authority. The files had in place assessments that had been reviewed at the residents annual review with the local authority to show how the residents needs had changed and how they were meeting the full need requirements of the individual. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. The service involves individuals in the planning of care which affects their lifestyle and quality of life. Staffs know and record the preferred communication style of the individual, and use proven methods that enable the person to lead a full life that promotes independence and choice. EVIDENCE: Comments from residents: ‘I like living at Old Oak Road’ ‘Staff are nice and they do help me to get ready when I am going out, and I go out nearly every day’ The Inspector looked at two residents files and both had up to date care plans in place that were very detailed showing the care need requirements in full throughout the individuals day. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 10 One of the residents does not communicate verbally and uses sign language; the signs used were recorded for staff to understand what was being communicated. The resident has lived at Old Oak Road for twenty years and is fully involved in the home, always assisting staff. The resident also has their own personal computer that has lots of pictures and the resident will go through the pictures to show what they want. One of the residents told the Inspector that they were having their (PCP) meeting that afternoon and they were looking forward to it. The PCP information for each individual is very good with lots of pictures, drawings and up to date information that shows how the individual is meeting their aims and aspirations. One PCP had photographs of a resident on holiday in Tobago; this was an aim of theirs to go back as they really enjoy spending time there, as that is where their family originate. In discussion with the Manager and looking at records the Inspector was told that at present one resident has an advocate that is assisting with financial affairs. The Inspector was told that the Manager is looking at applying for an advocate for one of the other residents, as they have no next of kin. This would assist the home in demonstrating that they are making the right decisions with and for that resident. The Inspector looked at the finances for two residents, receipts was in place that show what had been spent and on what. The balance in each resident’s records was correct. The Inspector looked at risk assessments for two residents, the risk assessments were reviewed and up dated January 2008. Each risk area identified had an action plan in place to show how staff would assist in minimising a risk. Residents are assisted to participate in activities that they enjoy, risk assessments were completed in most areas including a risk assessment for the resident who had recently been on holiday, the assessment was very thorough covering all areas of health and social care that maybe an issue whilst abroad. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team help with communication skills, both within the service and in the community, to enable residents to fully participate in daily living activities. EVIDENCE: Comments from residents: ‘I do lots of things I like doing and I am now going to a relationship group on a Monday with my girlfriend’. ‘I am going to options day service to meet all of my friends who also come here and I go to their home’. The Inspector looked at the activity plans for all residents that are varied to suit each individual’s interests. The Inspector spoke to two residents who were very happy with the activities they participated in. Activities included dance and drama classes, cookery, bag books, holidays, trips to local shops, meals out and lots of other activities. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 12 One resident was looking forward to attending a new activity in the community for people in relationships with their girlfriend. The Inspector looked at (PCP) that had lots of photographs of residents participating in activities both in the home and the community. One of the residents was on holiday in Tenerife with the support of staff, the Inspector was told that they had communicated with them and they were having a good time. A member of staff told the Inspector that weekend activities included going out for meals, shopping, going to the pictures, whatever the resident chose to do. Most of the residents all have family and friends visit them at Old Oak Road. Staff encourage and support all residents to continue relationships, visitors are made welcome and can spend time with the their family/friend in private if requested. Two of the residents are in relationships and are supported to see their partners when requested. One of the residents was escorted on holiday with their partner with staff support as part of their aims for 2007. All of the residents are assisted with personal care; the Inspector saw staff assisting residents in the privacy of their bedrooms and the bathroom. Staffs was seen to interact very well with all of the residents ‘asking and not telling’ and giving time for a response as not all residents living at the home can communicate verbally and use sign or different methods of communicating. The Inspector looked at the weekly menu that was varied with meals that were nutritionally balanced and also with resident’s choices. There was plenty of fresh fruit in the home. The Inspector saw staff offering drinks and food to residents throughout this inspection. The Inspector was told by a resident that they had recently attended a cookery class that they really enjoyed and were going to cook a meal for the other residents. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 20 and 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal and healthcare support using person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Personal healthcare plans are in place for all of the people living at Old Oak Road. EVIDENCE: All of the residents require full support to assist them with personal care. All of the residents have a full care plan that outlines the level of support required. One of the residents told the Inspector that they were happy with the support given as they had difficulty bathing themselves. There is a good ratio of male/female staff working at the home to provide intimate care; there is no issue at present with same gender care. The Inspector looked at two residents healthcare plans that had been completed in January 2008. Both healthcare plans were very informative and show that each individual has had all of their regular health checks including dental, optical and chiropody. One of the residents has regular meetings with a psychologist who had assessed and consulted with the Manager in October 2007 and written a behavioural plan that was very good in informing staff of what procedures to follow. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 14 All of the residents living at Old Oak Road have a GP and are assisted to visit when required, records were seen in place that show the GP will visit the home if requested. The Inspector looked at MAR sheet records all of the residents. All of the records were completed appropriately with no errors. The home now has the medication delivered in blister packs from the pharmacy. All medication is kept in a lockable cabinet in the staff room. The Inspector discussed the new professional advice on the safe management of controlled drugs in care homes with the Manager who is also the lead trainer for medication training for the organisation. The home does not at present have any controlled drugs, the Inspector was told by the Manager that she will discuss the new legal requirements with the organisation and make sure they put in place a controlled drugs cabinet that meet the requirements for future use. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 15 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): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of formats to help anyone living at or involved with the service to complain or make suggestions for improvement. EVIDENCE: The Inspector looked at the complaints procedure that is available in different formats, a copy of the pictorial complaint procedure was shown to the Inspector that was updated in 2005. There have been no complaints recorded in the home for the last 12 months. The CSCI was sent 4 surveys from residents that state they know the home’s complaint procedure and who they would speak to if they had a complaint. Two of the resident’s told the Inspector they are happy living at the home and have no problems. The Inspector looked at the home’s policy on protection that had been up dated in 2007, all of the relevant information was seen to be in place including (POVA) Protection of vulnerable adult procedures. All staff has attended (POVA) training. The incident that had occurred form the last inspection where a resident’s hair had been shaven was dealt with under safeguarding procedures in the appropriate way and as requested by the CSCI. An action plan is now in place for a hairdresser to visit the home on a regular basis. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 16 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): Standards 24,25 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that meets the specific needs of the people who live there. The home is comfortable and has a programme to improve the decoration, fixtures and fittings. EVIDENCE: The Inspector had a full tour of the home that was seen to be clean and tidy in all areas. There is the issue of remedial works on cracks throughout the home that has to be completed. A copy of a letter regarding a structural survey conducted 29th August 2007 that shows why the cracks have appeared throughout the home due to drainage problems. The letter also states there is no risk to people living at the home. The Manager told the Inspector that the works would be completed in six months as required by the landlords to make sure there is no more movement to the structure. The Inspector saw 4 residents’ bedrooms that were decorated in colours of their choice; there were also a lot of personal items in each room, photographs, pictures and sensory ornaments. Old Oak Road, 20 DS0000019140.V348576.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): Standards 32,33,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are now consistently enough staff available to meet the needs of the people using the service, with more staff now being on duty at peak times of activity. The staffing structure is based around delivering outcomes for residents and is not led by staff requirements. EVIDENCE: The Inspector was shown copies of staff training and development records; all staff has either attended the relevant mandatory training or is scheduled to attend in the next three months. There is two staff that has completed an NVQ level 2 and 3, and 5 staff are at this present time working towards and NVQ. There are staffs that are very highly skilled and have a lot of qualifications working at the home. The Inspector looked at staff rotas that show that there is adequate staffs on each shift that meets the care needs of all residents. There is 1 vacancy at the home at present that is covered by bank or agency staff. The Inspector was told that the extra member of staff on duty at the weekend has enabled the team to provide more activities for the residents. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 18 The Human Resources team based at Yarrow head office carries out all recruitment. CRB records were checked and all staff has up to date checks completed. Old Oak Road, 20 DS0000019140.V348576.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): Standards 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the required qualifications and experience and is competent to run the home. EVIDENCE: In discussion with the Manger the Inspector was told that she has started Registered Managers Award training (RMA). The Manager has worked in social and healthcare for many years and has lots of experience; the Manager is also a qualified Nurse. The Manager is also a training Coordinator for Yarrow. The Inspector looked at two residents files and each had questionnaires in place that had been completed at the end of 2007. The questionnaires were completed with a key worker and a family member. Both questionnaires had comments in that show that the individuals are happy living at Old Oak Road and had no problems at that time. Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 20 Yarrow collates all of their quality assurance information and produces a document annually to show outcomes of their audits. The Inspector had discussions with two of the residents living at Old Oak Road who were able to express their feelings about the staff and the home, and they stated they were happy. The home is now having regular PIC visits by the organisation, the Inspector was shown records for the last 5 months that had very positive comments recorded. The organisation must make sure that the landlords complete all remedial works necessary in the timescale required and redecoration of the areas that needs to be completed throughout the house. The Water temperatures records show that they are to low, all thermostats to be checked and set at the correct temperature. Old Oak Road, 20 DS0000019140.V348576.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 x 4 x 5 x 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 2 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 x 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 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x x 3 3 x 3 x x 2 x Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 22 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 YA42 Regulation 23 Requirement The Manager must make sure that all water outlets are maintained as water temperatures are to low, all thermostats to be checked and set at the correct temperature. Timescale for action 14/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: 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 © 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 Old Oak Road, 20 DS0000019140.V348576.R01.S.doc Version 5.2 Page 24 - 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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