Inspection on 29/09/05 for Princes Road, 46

This inspection was carried out on 29th 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

Princes Road, 46 22/06/06

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 Sandy Patrick Unannounced Inspection 29th September 2005 10:00 Princes Road, 46 DS0000017387.V256106.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 Princes Road, 46 DS0000017387.V256106.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. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 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.V256106.R01.S.doc Version 5.0 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 28th April 2005 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. In the past the service was jointly managed by the Kingston Primary Care Trust. This arrangement ceased in 2004. 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. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 29th September 2005, and was unannounced. The Manager was present throughout the inspection. The Inspector also met two service users and staff on duty. The Inspector was made welcome by all. Staff on duty and the service users were friendly with each other and the atmosphere at the home was relaxed and happy. Staff treated service users with respect and were seen to offer choices and support them to make decisions. What the service does well: What has improved since the last inspection? Since the last inspection there has been work to develop person centred plans further and service users have been involved in all aspects of this, including training. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 Page 6 Some service users have started new college courses and day opportunities which meet their needs and wishes. All service users have been on holiday. Service users have had a range of personal achievements. recognises and values these. The service One service user participated in a local event, where they had a display of their photographs and spoke with members of the public about some of their experiences and achievements. There has been further work to develop accessible information and menu planning. Further work to monitor the quality of the service has taken place in original and innovative ways. Parts of the building have been redecorated. The staff team have undertaken a range of training. 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.V256106.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 Princes Road, 46 DS0000017387.V256106.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): 1 Prospective and current service users are given a wide range of information about the service and are supported to understand this through various communication techniques. EVIDENCE: The Registered Person has produced a comprehensive Statement of Purpose for the home. This includes the required areas. The Service User Guide has been developed to personalise information for each service user. All service users have been given a copy of the document, which includes key information regarding their care, rights, rules, costs and a summary of the complaints procedure. Information is presented in words, pictures, symbols and using photographs. The document contains a sample of comments and views of the current service user group. Photographs of all staff, including regularly used temporary staff are included within the guide. There is also a video representation to the Statement of Purpose and Service User Guide. There have been no admissions to the home since the last inspection. Princes Road, 46 DS0000017387.V256106.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 & 9 Service users have participated in the development of their own person centred plans, which reflect their needs and wishes in an accessible format. The home has undertaken some commendable work in supporting service users to have a better understanding of the information written about them and in supporting them to make informed choices. EVIDENCE: Individual service user plans are in place for all service users. Over the last year staff and service users have been working together to create person centred plans (PCP), which the service user owns and holds in their own room. They share the information with staff. All service users now have their own plans and most of these are complete. One service user showed the Inspector their plan and a keyworker showed the Inspector another plan. These were well designed and incorporated pictures, photographs, words and symbols to outline individual needs and wishes. All staff have attended a series of training sessions in connection with this and service users have been offered training to support their understanding of the PCP process. Two service users and a member of staff were due to attend a PCP conference shortly after the inspection. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 Page 10 Service users and staff are commended for their hard work to produce these plans. Further information on individual needs, wishes and strengths, guidelines and advice from health care professionals accompany PCPs. The keyworker of one service user showed the Inspector the service user’s collection of photographs, which recorded their achievements since they moved to the home. This service user participated in a local event to celebrate successes and achievements for people using the Learning Disability services. This service user displayed their photographs and spoke with visitors about their experiences before and since living at Princes Road. The staff at the home have been trained in various communication techniques and make frequent use of photographs to support written information and to help service users to make informed choices. The wishes of service users are clearly reflected within PCPs. Review meetings are arranged on a regular basis and the meeting takes the format of the service user’s choice. Where service users do not wish to be involved in a large review meeting, separate meetings with the placing authority and other parties are arranged as required. Service users are supported to make decisions about the home and their lives on a daily basis. Service user meetings are held monthly and various issues are discussed at these. Service users are able to chose décor for the home and chose and plan menus and activities. Service user meetings are recorded in words and symbols. The Manager reported that each month service users discussed a particular issue relating to the quality of the service as well as discussing the general needs of the home. The next service user meeting was due to include a discussion on the house rules. All service users had been given written and pictorial information before the meeting and keyworkers support service users to think of the issues they might want to raise regarding these at the meeting. The house rules will be agreed at the meeting and then all service users will be given a copy of them. At the last service user meeting service users discussed some of the activities that they had enjoyed over the summer. There has been significant work to promote clearer communication and better understanding. The home has made excellent use of photography and staff are reviewing all documents to look at accessibility of information for service users. Individual assessments of risk are in place for all service users and are subject to regular review. Princes Road, 46 DS0000017387.V256106.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): 11, 12, 13, 14, 16 & 17 Service users are supported to understand and develop personal, social, communication and independent living skills. Service users are able to contribute in a range of activities and their educational and employment needs met. A variety of freshly prepared and wholesome food is available and service users make informed choices about what they want to eat. EVIDENCE: Service users participate in a wide range of activities, both within and outside of the home. All service users have planned programmes of daytime activities. These include college courses, accessing the local resource centres and employment. Service users are also supported by staff to learn and maintain skills in the community and at home. These include menu planning, shopping, cleaning, looking after themselves and money handling. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 Page 12 Service users are expected to respect one another and live harmoniously. The house rules designed to support everyone to live together in a happy environment are being reviewed by all service users at their next meeting. Some service users have started new college course this year. Others continue to attend the same course. These are designed to meet individual needs and include music lessons, drama, assertiveness and literacy. On the day of the inspection one service user was going to a college course. Staff were seen to support them to understand the money they needed to take to the college with them. Service users are supported to respect the environment and participate in recycling. Service users participate in individual and group leisure activities. All service users have been on holiday this year. At a recent service user meeting and individually service users were asked to speak about the activities they had had over the summer, what they liked about these and what they would like to do again. They were also asked what new things they would like to try. The results of these questions were compiled into a report in pictures and words which is available to service users to view and talk about. The Manager stated that they planned to support service users to try the new activities which they had identified. The Manager told the Inspector that a support worker from the local resource centre was visiting the home and would be working with staff and service users to look at individual educational and leisure needs and how these could be supported. The Inspector saw a wide range of photographs from holidays and various social events and activities. These and the results of the survey about summer activities indicated that service users were very happy with the support they received in this area. A day trip to France is planned for later in the Autumn. Service users are involved in the planning of, shopping for and preparation of meals. They have developed menu cards which help them to make informed choices about the food that they wish to buy and eat. Photographs of food products and ready made meals are used and service users choose from these. Menu cards are bright and clear and are kept on display to support service users to know what has been chosen for the week. The Manager reported that staff and service users are continuously adding to the collection of menu cards with new ideas and recipes. The kitchens at the home are well stocked with fresh food and fruit and snacks are available throughout the day and night. Princes Road, 46 DS0000017387.V256106.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): 18, 19 & 20 Personal and health care and medication needs are appropriately recorded, monitored and met. Staff support service users to understand their own needs and the importance of good health. EVIDENCE: Personal and health care needs are recorded within service user plans. Additional guidelines and information from health care professionals are included. The staff work closely with health care professionals to make sure that all health care needs are met. The Manager reported that staff are developing person centred health care plans, so that service users can understand and own these. Service users are supported to understand about keeping healthy. One service users told the Inspector that they went to a keep fit class and that they had an exercise bike in their room. The staff spoke about how they promoted a healthy diet. There is evidence of health care monitoring on a regular basis. There is an appropriate procedure on medication. Medication is stored and labelled correctly. There is a range of information on different medications used including descriptions of the actual medication and side effects. Medication records were completed accurately. Princes Road, 46 DS0000017387.V256106.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 & 23 There is an appropriate complaints procedure which is available to service users. There are appropriate procedures designed to protect service users from harm and abuse. EVIDENCE: There is an appropriate complaints procedure. This is included within the Service User Guide, issued to all service users. Information for service users includes named photographs of all staff and people named within the complaints procedure to support recognition. There have been no complaints at the home since the last inspection. The London Borough of Richmond has appropriate Protection of Vulnerable Adults and Whistle Blowing procedures which are available within the home. All staff undertake training in recognising and reporting abuse. The recruitment process for staff ensures that thorough checks, including criminal record checks, take place prior to employment. Princes Road, 46 DS0000017387.V256106.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, 25, 26, 27, 28, 29 & 30 The environment is safe, well maintained and accessible. Service users have unrestricted access to all communal areas of the home and are involved in choosing décor and furnishings. Private space is personalised. The home was clean throughout. EVIDENCE: The home is a large detached property situated in a residential area of Teddington. There is a well kept garden with a patio and lawn area. The property is divided into two flats. There is internal access between the flats. The ground floor is level access in order to meet the needs of wheelchair users. The home was well maintained and pleasantly decorated throughout. Over the past year the hot water system has been improved, carpets throughout communal areas have been replaced and one bathroom has been decorated and equipped with a new bath. The Manager reported that communal areas and bedrooms were due to be painted later in the year and the outside of the home decorated in 2006. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 Page 16 Communal and private space meet size requirements. There is a kitchen, dining area, laundry room and lounge within each flat. These are appropriately equipped. Bedrooms are personalised by the occupants. There are a number of environmental adaptations designed to support service users. These include hoists, specialist baths and a variety of lifting and handling equipment. The ground floor is equipped with low level light switches and a low level kitchen. The Manager reported that health care professionals had assessed service users for equipment needs and had regular input into the home. The home was clean and well maintained on the day of the inspection. There are appropriate procedures for the laundering of clothes, infection control, disposal of clinical waste and Control of Substances Hazardous to Health. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 & 36 The staff team are employed in sufficient number and have a good awareness of the needs of service users. The staff receive regular training and support to enable them to fulfil their roles. EVIDENCE: There have been no staff changes in the past year and changes before this have been infrequent. This consistency of approach has undoubtedly been supportive and the staff team know the needs of service users well. The Manager has consistently praised the staff team for their hard work and dedication to the service. The staff team have embraced the aims and objectives of the home and work closely with the Manager and service users to look at service development. There is a small team of temporary staff who cover leave and other additional staffing needs. The Manager reported that the home uses the same familiar staff for this. One member of staff was about to start their NVQ Level 3 qualification. All staff members have their qualification or are working towards it. On the day of the inspection the Deputy Manager (who is an Assessor) and a staff member Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 Page 18 were discussing NVQ work. Some of the innovative projects at the home have been used to evidence work for NVQs. The London Borough of Richmond has a comprehensive training programme which offers staff a range of basic and specific training. The staff on duty reported that they attended regular training. One member of staff told the Inspector that the had recently undertaken dementia training and were due to go to PCP conference. Another member of staff had recently attended protection of vulnerable adult training. All staff are trained in basic first aid, food hygiene, manual handling, protection of vulnerable adults and fire safety. All staff are trained to use the computer and further training is going to take place. Two members of staff are due to start a Makaton course in January 2006. All staff receive regular supervision and appraisals. This is recorded. Regular team meetings are held and minuted. There are good systems for formal support and communication and staff use these well. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 The Manager is appropriately qualified and experienced. The management approach is open, inclusive and positive. The quality assurance policy is implemented in a way which allows for self monitoring and service development. Systems are in place to promote good health and safety practices and a safe environment. EVIDENCE: The Manager has worked at the home since it opened over ten years ago. She has been employed as the Manager for four years. She has consistently demonstrated an in-depth knowledge of the service and the needs of those who live there. The Manager has achieved her Registered Managers Award and has almost completed her NVQ Level 4. Her NVQ `Assessor met with her on the day of the inspection. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 Page 20 The management approach is inclusive and service users and staff are asked for their opinions on the running of the service, through individual and group meetings. Staff on duty reported that they were well supported and service users indicated that they were happy. Service user meetings and other records evidence regular consultation with service users about the home. There is a comprehensive quality assurance programme. In depth monthly inspections are conducted by the organisation’s Quality Assurance Manager. The Manager and staff also evidence other quality checks, monitoring and consultation. Some really positive work has taken place in which service users have been central to the feedback and suggestions for improvements to the service. A quality issue is discussed at each service user meeting and is appropriately recorded. There is evidence of regular checks made on health and safety, including fire safety. Risk assessments are regularly reviewed. All accidents and incidents are recorded and monitored. Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Princes Road, 46 Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 4 X X 3 X DS0000017387.V256106.R01.S.doc Version 5.0 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. 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. Refer to Standard Good Practice Recommendations Princes Road, 46 DS0000017387.V256106.R01.S.doc Version 5.0 Page 23 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. 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