Inspection on 05/12/05 for Perryn Road 23

This inspection was carried out on 5th December 2005.

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

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

Other inspections for this house

Perryn Road 23 01/02/07

Perryn Road 23 01/06/05

Perryn Road 23 10/01/05

Perryn Road 23 17/05/04

Perryn Road 23 01/07/03

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 Perryn Road, 23 Acton London W3 7LS Lead Inspector Mr Gavin Thomas Unannounced Inspection 12.10 5 December 2005 th Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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 Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Perryn Road, 23 Address Acton London W3 7LS 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) 0208 749 8273 0208 944 8900 Care Management Group Limited Mr Rennie Lee Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2005 Brief Description of the Service: 23 Perryn Road has operated under the Care Management Group (CMG), as a care home for adults with learning disabilities since 1998. Some of the service users have associated needs including a mental health diagnosis and challenging behaviours. The building is a large double fronted detached property in a residential area close to Acton High Street with shopping and public transport facilities. External features includes an enclosed rear garden, most of which is laid to lawn. Off road parking is provided for up to two vehicles. The age range of the service users is between 20 and 50 years. At the time of this inspection, there were eight service users accommodated. All service users are accommodated in single bedrooms. Bedrooms are situated on the ground, first and second floors. Because of the age and design of the building, the size of the bedrooms varies greatly. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of three and half hours. During this time, the Inspector met with the Registered Manager, one Senior Support Worker and one Support Worker. All service users were out at the time of this inspection. One service user was visiting a friend, one service user was out with staff and six service users were at day centres/college. The Inspector met briefly with two service users when they returned home. Both service users said they were well. One service user said they were looking forward to the annual Christmas party. One service user most recently admitted to the home declined a conversation with the Inspector. The atmosphere in the home was pleasant and welcoming. This inspection took place on a cold day. The central heating system was on and the home was warm throughout. Five service users completed surveys for the purpose of this inspection. Overall responses received were very positive. The outcomes were as follows: Three service users stated that they like living at the home. One service user stated that sometimes they like living at the home. Four service users stated that they feel well cared for. They are treated well by staff, their privacy is respected, they like the food, they feel safe at the home and they would know who to speak to if they were unhappy. One service user stated that they would like to be more involved in decision with regards to holidays. One service user stated that they did not like living at the home. The service user stated that they would prefer to live independently in a flat. The Inspector takes this opportunity in thanking all staff and service users who contributed to this inspection. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 6 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. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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 Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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 the following standard(s): 4 The procedures in place for introducing prospective service users to the home were thorough. EVIDENCE: Procedures were in place for introducing prospective service users to the home. The service user most recently admitted, had visited the home on two occasions prior to admission. These visits included overnight stays. The Registered Manager confirmed that the home was very involved with the admissions procedure. This included one senior member of staff spending time with the service user in their previous placement prior to admission. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 & 10 Good care planning systems were in place. This included associated care planning documents such as monitoring and tracking records. The home has made good progress in supporting and enabling some service users to make decisions about their lives. This includes support strategies for maximising independence. EVIDENCE: Care plans were in place for all service users. One care plan was examined for the purpose of this inspection. The care plan was divided into different sections. This included personal information, goals and action plans, monitoring and observation records, service user’s likes/dislikes, behavioural patterns and activities. The staff were also working with the service user to create their life picture. The Registered Manager confirmed that the care plan examined was generated from the service users initial assessments and the Care Programme Approach. The service user had signed the care plan. A review meeting was scheduled for the care plan to be reviewed in accordance with the Care Programme Approach. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 10 The home encourages service users to make decisions about their lives. Where service users have limited verbal communication skills, additional support or other means of communication is provided such as pictures and photographs to help service users make decisions. The Registered Manager explained that when necessary, the Community Team for People with Learning Disabilities (CTPLD) provides advice and support for engaging service users in consultation processes. This includes assessments with the Speech and Language Therapist to identify appropriate methods of communication, which service users may benefit from. Independent advocates were not involved with any of the service users. The Registered Manager said that service users would be supported in finding an independent advocate or service users would be supported in attending a selfadvocacy group if they so wished. A policy on confidentiality was in place. The two staff on duty said they were aware of this policy. The staff were also aware of what action would be taken by the organisation if staff were in breach of the codes of confidentiality. Confidential records are stored securely in locked cabinets. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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 the following standard(s): 16 & 17 The home is proactive in establishing ways to engage service users in domestic tasks. This includes good recording systems to monitor service users involvement and progress. EVIDENCE: All service users have keys to their bedrooms. In the event of an emergency, bedroom and bathroom doors can be opened from the outside. The Senior Support Worker confirmed that service users receive their mail unopened. Service users have access to all communal rooms in the home. The door leading to the rear garden is normally locked. The rear garden backs on to the rail way line. A fence and trees separates the two. Staff confirmed that service users are not at risk and are supervised in the garden at all times. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 12 Service users participate in a range of housekeeping tasks such as vacuuming, mopping, setting the table, light kitchen duties and laundry duties. Service users are encouraged to maintain the upkeep of their bedrooms. Varying levels of staff support is provided to ensure service users safety and to ensure that they complete all tasks successfully. Four weekly menus were in place. Menus are reviewed and updated with service users every six months and at other times when requested by service users. Pictures of food are displayed in the dining room to assist service users in making choices. Menus examined included foods such as pies, beef mince, meat chops, fish, soups, a variety of vegetables, roast dinners, curry, cooked breakfasts and sandwiches. The main meal of the day is served in the evening. Two service users take packed lunches to their respective day placements. All other service users have lunch time meals provided at their college or day placements. Light meals are served in the home at lunch times for service users not attending external day or further education placements. The home was not catering for any specialist diets at the time of this inspection. The Registered Manager explained that the menu is changed in accordance with service users preferences and not for medical/health reasons. The home monitors service users food intake if there are any concerns regarding weight loss or weight gain. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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 the following standard(s): 21 Discussions about service users’ last wishes are dealt with sensitively. EVIDENCE: The Registered Manager confirmed that none of the service users had a serious/chronic illness, requiring nursing or palliative care. Where possible, the home obtains from service users and/or their representatives, last wishes to be carried out if a service user dies whilst living in the home. The home records any information given about managing the death of a service user such as the type of burial and who to contact in the event of death. This information is stored on individual service users files. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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 the following standard(s): 22 The procedures in place for managing and investigating complaints were satisfactory. EVIDENCE: A complaints policy and procedure was in place. The complaints procedure is simplified for the benefit of service users. This was displayed in the home. A visitors/staff complaints procedure was displayed in the hallway. The contact details for the Commission for Social Care Inspection must be inserted in the visitor’s complaints procedure. A record of complaints was in place. The Registered Manager reported that the home had not received any complaints since the last inspection. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 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 the following standard(s): 24 & 30 The home does well in consulting service users on colour schemes, furniture and fixtures for their bedrooms. Although improvements had been made to the premises, further work must be carried out to improve areas of the home as identified below. EVIDENCE: The location of the home is ideal for easy access to local amenities, local transport links and relevant support services. The home is in keeping with local style and ambience. CCTV cameras are not used anywhere in the home. The overall areas of the home inspected were warm and comfortable. However, it was noted that some areas must be improved upon as follows: Toilet - ground floor • • • The toilet seat must be repaired or replaced. Window covering must be provided to maximise privacy. The metal strip, which holds down the floor covering, was raised. This must be secured for safety reasons and to enable the toilet door to shut properly. DS0000027747.V261072.R01.S.doc Version 5.0 Page 16 Perryn Road, 23 Hallway – ground floor • Cracks were visible on the wall near the rear exit. As a result, the wallpaper was also damaged. These cracks must be assessed and repair work carried out to the wall. Dining room • The dining rooms were stained and marked. These walls must be redecorated to maintain a homely appearance. • The broken shelving unit must be repaired or replaced for safety reasons. Bedroom – First floor • The electrical socket in one bedroom was loose. This must be secured to the wall for safety reasons. Office/sleeping- in room • The décor in the office and sleeping-in room requires updating. The carpet was badly stained. This must be cleaned or replaced to maintain a more professional image. The door leading into the dining room is a designated fire door. This door was propped open with a chair. The home must refrain from this practice, which is judged to be unsafe. Alternate devices must be used for this door to be kept open. Any device used must be approved and in keeping with Fire Safety Regulations. Staff had arranged for the maintenance person to visit the home to repair a faulty hot water tap in the kitchen. This work was scheduled to take place on 06/12/05. Some work had been carried out in the basement to resolve the dampness. This work still needs to be completed. Good progress had been made in improving the standard of décor in service users bedrooms. Three bedrooms examined were well presented. The Registered Manager confirmed that service users selected the colour schemes. Service users also chose their own furniture. The fixtures and fittings seen in the three bedrooms were judged to be of good quality. The floral displays and candleholders displayed in the entrance hall and in windowsills on the staircase create a more homely appearance. Policies and procedures on the control of infection were in place. A new washing machine was installed in November 2005. The washing machine and tumble dryer are now situated in a utility room on the ground floor. The utility room is situated next to the dining room but away from the kitchen. Where Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 17 possible, service users are involved in laundry duties. The Registered Manager confirmed that all soiled clothing and linen is transported to the utility room in covered laundry bins. Washbasins are provided in all bedrooms, bathrooms and toilets. Disposable paper towels and liquid soap are used in all communal washrooms. Mal odour was present in one bedroom. The Registered Manager was aware of this and action was being taken to address the matter. Appropriate floor covering for this room was discussed with the Registered Manager. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 & 34 The home does well in maintaining a stable and permanent staff team. Satisfactory recruitment procedures were in place. EVIDENCE: The staff team consists of: • Registered Manager. • One Deputy Manager. • One Senior Support Worker (grade 1). • Two Support Workers (grade 2). • Seven Support Workers (grade 1). • Two waking night staff. The home has interviewed and selected a part time domestic staff. This person will be appointed once all recruitment checks have been done. Staff spoken to, were knowledgeable about the overall needs of service users and how these needs are met. The staff explained that they were still in the process of establishing relationships with one service user most recently admitted to the home. Relevant training must be provided for the staff to develop a better understanding of the health needs of one service user most recently admitted to the home. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 19 The Registered Manager works closely with staff and service users to ensure that all staff understands service users needs and that these needs are met consistently. The Registered Manager was of the opinion that the Community Team for People with Learning Disabilities (CTPLD) are an asset to the home for providing a range of services and professional advice and support to staff and service users. Standard 32.6 of the National Minimum Standards for Care Homes for Adults (18-65) states that 50 of care staff (including agency staff) in the home achieve a care NVQ 2 (by 2005). Six staff were working towards an NVQ Level 2 in care and one staff was working towards an NVQ Level 3 in care. The Registered Manager said that all staff were expected to complete this course by the end of December 2005. Additional staff would be registered to undertake the NVQ Level 2 training once the staff currently working towards the course have completed it. Progress towards this will be monitored at the next inspection. The home was fully staffed at the time of this inspection. The Registered Manager said that the home was not dependent on external agency staff to make up the full compliment of the staff team. Prospective staff are interviewed at the home. The minimum of two staff carries out interviews. The organisation’s Human Resources Department is responsible for carrying out all recruitment checks. Copies of recruitment checks are supplied to the home. The Registered Manager confirmed that Criminal Records Bureau (CRB) checks have been carried out on all staff. CRB disclosures are retained at the organisation’s Head Office. Details are supplied to the home confirming the outcome of CRB checks for each member of staff. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 38 The Registered Manager communicates a clear sense of direction and leadership. Good management strategies were in place to maintain openness and transparency. EVIDENCE: The Manager has been in his current post since July 2003. The Commission for Social Care Inspection has now formally registered the Manager for this establishment. The Registered Manager has a Bsc in Psychology and Health studies, a Post Graduate – Integrative certificate in Counselling and Psychology, a Post Graduate Diploma in Counselling and a NCFE in Counselling. The Registered Manager has undertaken training in adult protection, fire safety, budgeting, food hygiene, First Aid, grievance procedures and quality systems within the last year. The Registered Manager said that he has established good working relationships with the staff team and service users. This includes strategies for empowering staff, encouraging staff to make decisions and encouraging service users to speak openly about their feelings, views and opinions. The Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 21 Registered Manager said that the home is always exploring opportunities to develop the provisions of the service. This includes service users involvement in the community and daytime activities. Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 22 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 x x 3 x Standard No 22 23 Score 2 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x 2 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Perryn Road, 23 Score x x x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x DS0000027747.V261072.R01.S.doc Version 5.0 Page 23 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 22 Regulation 22(7)(a) Requirement Timescale for action 31/01/06 2. 24 3. 24 4. 24 The contact details for the Commission for Social Care Inspection must be inserted in the visitor’s complaints procedure. 31/01/06 23(2)(b)(c)(e) The following work must be carried out in the ground floor toilet. • The toilet seat must be repaired or replaced. • Window covering must be provided to maximise privacy. • The metal strip, which holds down the covering, must be secured for safety reasons and for the toilet door to shut properly. 23(2)(b)(d) Cracks on the wall in the 28/02/06 hallway on the ground floor must be assessed and necessary repaired work carried out. The damaged wall covering must also be replaced. 23(2)(c)(d) The following work must be 28/02/05 carried out in the dining room. DS0000027747.V261072.R01.S.doc Version 5.0 Perryn Road, 23 Page 24 5. 24 13(4)(c) 6. 24 23(2)(d) 7. 24 23(4)(b) 8. 32 18(1)(a)(c)(i) The walls must be redecorated to maintain a homely appearance. • The broken shelving unit must be repaired or replaced for safety reasons. The loose electrical socket in one bedroom on the first floor must be secured to the wall for safety reasons. The décor in the office and sleeping-in room must be updated. The badly stained carpet in the office must be replaced to maintain a more professional image to staff, service users and their visitors. The dining room door is a designated fire door. The home must refrain from using a chair to keep this door opened. Relevant training must be provided for the staff to understand and meet the health needs of the service user most recently admitted to the home. • 06/01/06 28/02/05 06/01/06 28/02/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Perryn Road, 23 DS0000027747.V261072.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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