Inspection on 22/06/06 for Princes Road, 46

This inspection was carried out on 22nd June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Princes Road, 46 29/09/05

Princes Road, 46 27/09/04

Princes Road, 46 22/04/04

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 Princes Road, 46 46 Princes Road Teddington Middlesex TW11 0RU Lead Inspector Adrian Gordon Unannounced Inspection 22nd June 2006 10:00 Princes Road, 46 DS0000017387.V300559.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 Princes Road, 46 DS0000017387.V300559.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. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Princes Road, 46 Address 46 Princes Road Teddington Middlesex TW11 0RU 020 8614 8090 020 8614 8090 c.gregg@richmond.gov.uk 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) London Borough of Richmond upon Thames Mrs Catherine Gregg Care Home 6 Category(ies) of Learning disability (6), Physical disability (2) registration, with number of places Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can admit one named service user over the age of 65 years. Date of last inspection 29/09/05 Brief Description of the Service: 46 Princes Road is a care home providing residential care and accommodation for six service users with a learning disability. The home has been operating since 1994. The building is owned by London Quadrant Housing Association. The service is managed by the London Borough of Richmond. The building has three storeys and is divided into two flats. There is an internal door between the two flats, which can be accessed by service users. The ground floor flat has level access in order to meet the needs of service users who have wheelchairs. All bedrooms are for single occupancy and two have en suite facilities. The home is located close to shops, pubs and other local amenities. Information about the service is available in the Statement of Purpose and Service User Guide. Fees are not applicable to this home as it is an in-house service funded by the London Borough of Richmond. However, residents are expected to pay towards holidays. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and completed over the course of one day. It consisted of examination of records, a tour of the premises, observation of care practice, meeting all the residents and talking to six staff, including the manager. On the day, it was also possible to meet one relative and the Quality Development Officer from Richmond. Two feedback questionnaires were received from relatives. What the service does well: What has improved since the last inspection? Further work has taken place to develop Person Centred Plans and Health Action Plans and this will be continued. The team is constantly looking for ways to further improve the service and this is to be commended. A Quality Assurance Survey took place at the end of 2005 and work is continuing to ensure that the results of the survey properly reflect what is important to residents, and that action is taken to address any issues raised. The home has been decorated internally and was seen to be clean, fresh and bright. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 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. Princes Road, 46 DS0000017387.V300559.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 Princes Road, 46 DS0000017387.V300559.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents have the information they need to make informed choices about the home. EVIDENCE: The home has a comprehensive Statement of Purpose and Service User Guide. All residents have been given a copy of the Guide which has been developed to make it personal for each resident. Information is provided in ways which are meaningful to residents , for example, pictures, symbols and photos. Photographs of staff are included which will help new residents become familiar with the team. A guide to the home is also available on video. The manager said that there had been no new admissions to the home over the last three years. If a new referral was made they would be allocated a keyworker who would look at their needs from every possible angle to ensure that the home was suitable and that their needs could be met. Princes Road, 46 DS0000017387.V300559.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents are enabled to participate in care planning by staff supporting them to have a better understanding of what is written about them. EVIDENCE: Resident files were of a good standard and showed that Person Centred Plans (PCPs) are in place. These plans are of an excellent standard and include information about the home, personal goals and friends. A personal profile includes details of likes, dislikes, strengths and needs. All the information is presented in a meaningful way with the use of pictures. PCPs were seen to be up to date and reviewed It is clear that residents are involved in the development of these plans and choosing of pictures. This was confirmed by two residents. Monthly reports by the keyworker summarise recent developments and achievements. A weekly timetable is also produced, again using pictures, which is then owned by the resident. A summary of the last year was also seen in pictorial format. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 10 Residents views are central to any decision made about their lives. Wherever possible staff try to communicate with residents in a way which allows them to have a say. This is done through keywork sessions, where PCP’s are explained, or through reviews and resident meetings. For example, residents choose what is on the menu which is in pictorial form. The London Borough of Richmond is keen to make sure that the results of the recent Quality Assurance Survey are fed back in way that can be understood, for example using audio and DVD. Risk assessment are in place for residents and these are regularly reviewed. The manager gave an example of a way in which these are used by talking about one resident who had the opportunity to have a change in medication. This was a risk in doing this of an increase in seizures, but the resident agreed to take this risk after all the information was presented to them. Staff were then able to support the resident through the use of risk assessment. Princes Road, 46 DS0000017387.V300559.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 at least once during a 12 month period. 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 the service. Residents lead active lifestyles which allow for personal development. EVIDENCE: Residents take part in a range of activities inside and outside the home. Each resident has a weekly timetable in pictorial form which supports them to understand what they will be doing. Some residents attend college courses and day centres. One resident goes regularly to a Horticultural Centre. Another resident takes part in keep fit and attends guitar lessons. All residents have the opportunity to go on a holiday each year. Residents are able to have visitors at the home if they wish. Two relatives confirmed that they go to the home regularly and are made welcome by staff. When asked about residents sexual needs the manager said that one resident will talk to a male staff member if they had any sensitive issues they wanted to discuss. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 12 Residents are involved in planning the menus and make use of menu cards and photos of food products they like. The current weeks menu showed a range of healthy and nutritious food. Records of food eaten at the home are not maintained, however the manager changed a daily recording form on the day of inspection so that meal are now included. Princes Road, 46 DS0000017387.V300559.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported to be aware of their personal health needs and how the home will meet them. EVIDENCE: Personal and healthcare needs are included in Person Centred Plans. Staff are currently working on Health Action Plans for all the residents. One if these was seen and included information particular to that resident, for example, the optician, tablets, exercise and healthy eating. The resident said that they had been involved in the plan and had chosen pictures to be included. They also confirmed that they understood what was in it. Residents are also supported to understand about being healthy. One resident was attending an exercise class on the day of inspection which they said they enjoyed. A relative fedback that the home had supported the resident to lose weight and keep fit. Another relative commented that ‘staff attend well to health concerns’. Specialist external support is available if needed and evidence was seen of this in resident files. These include dentists, opticians and hospital specialists. If a Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 14 resident has a medical appointment on a particular day, staff sign to state they are aware of it. Each resident has their own medication profile. The staff team is stable and consistent and know residents well but in order to fully protect residents from maladministration it would be good practice for each sheet to include a photo. Information in the file includes sample staff signatures, epilepsy care plans and rectal diazepam care plans. Side effects are also noted. Medication Administration Record sheets were completed accurately. Princes Road, 46 DS0000017387.V300559.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are protected by the procedures for complaining and the Protection of Vulnerable Adults. EVIDENCE: There have been no complaints since the last inspection. Complaint procedures are made available to all residents in the Service User Guide which was seen in one residents bedroom. This resident confirmed they knew how to complain if they wanted to. Residents are also encouraged to express their views in the residents meeting. The London Borough of Richmond has Protection of Vulnerable Adults and Whistleblowing procedures available in the home. Staff have all completed training in this area. Princes Road, 46 DS0000017387.V300559.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents benefit from living in a safe and homely environment which meets their needs. EVIDENCE: Externally, Princes Road fits in with other houses on the street and doesn’t stand out as a care home. The inside of the property has been recently decorated and was fresh, clean and bright. One relative fed back that ‘…the cleanliness and tidiness is always very good’. The ground floor accommodation is accessible to wheelchair users and there is separate accommodation on the first floor. However, residents are able to come and go between the two floors as long as residents who live there don’t object. To the rear is a well maintained garden which provides accessible outside space for residents to enjoy. Bedrooms reflected individual tastes and include adaptations to meet resident needs, for example one resident showed me the tracking which leads from their bed to the ensuite bathroom. There are other adaptations in the home to Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 17 support residents. These include hoists, specialist baths, low level light switches and a low level kitchen on the ground floor. There were no health and safety concerns about the environment. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 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, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A stable and competent staff team ensures that residents welfare is made central to working practices. EVIDENCE: Staff spoken to on the day of inspection were all familiar with the residents and had been working at the home for over a year. The staff group is stable and committed to providing good care to residents which is focussed on individual needs. Feedback confirmed that staff are dedicated and enjoy working there. One staff member commented that they ‘…are all committed to providing an excellent service.’ A relative also stated that ‘credit must go to ALL the staff’. One member of staff is qualified as an NVQ assessor and all staff except for one have completed NVQ2 in care, or are working towards it. A staff training audit shows what training areas still need to be completed and a comprehensive training programme through the London Borough of Richmond allows staff to access training as needed. Supervision and appraisal records show that these take place regularly and are recorded. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 19 Recruitment records confirmed that all the necessary checks have been completed, however the registered person should consider updating Criminal Record Bureau checks if they are over three years old. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 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, 39, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents can be sure that their views are listened to and acted upon through the use of excellent monitoring systems. EVIDENCE: The manager has now completed the Registered Managers Award, having undertaken NVQ4 in care and the Certificate in Management Studies. She is committed to providing a service to residents which is focussed on individual needs, and which strives to ensure their voice is central to any decisions made in the home. This ethos runs throughout the home and was evident when speaking to staff on the day. One relative commented that ‘Good management and a stable workforce achieve…good results’. A Quality Development Officer (QDO) visits the home monthly and was seen on the day of inspection. She discussed the recent Quality Assurance Survey which was carried out at the end of 2005. This was aimed at residents and Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 21 their families, focussing on what was important to them e.g. respect, safety, health. Staff were asked to work with each resident to ensure that their views were included and information provided to them was made easy to understand. The QDO bases each monthly visit on an outcome of the report, for example, this time she was looking at ‘Do you feel safe?’. The results of the survey are reported in a newsletter which is made easy for residents to understand. Performance targets will also be made available in audio and DVD formats. The manager said that staff are always looking at ways to improve communication with residents, in particular allowing residents to communicate in their own way. For example, a resident makes it clear that they want to go to the pub by putting their coat on and starting to walk down the road. Rather than seeing this as risky behaviour it is seen as making a choice. Resident meetings take place monthly and each resident has a folder with their own ground rules for the meeting in pictorial form. Two residents are unable to participate fully and so the group work together to think about what they might have to say. Health and safety checks are up to date and risk assessments regularly reviewed. All accidents and incidents are recorded appropriately. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 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 Standard No Score 1 4 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 3 25 X 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 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 3 3 X 3 4 4 X X 3 X Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 2 Refer to Standard YA34 YA20 Good Practice Recommendations The registered person should ensure that Criminal Records Bureau Disclosures are renewed at least once every three years. The registered person should ensure that there is a photo of each resident on their medication profile. Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Princes Road, 46 DS0000017387.V300559.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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