Inspection on 22/02/06 for Queens Road, 14

This inspection was carried out on 22nd February 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Queens Road, 14 14/08/06

Queens Road, 14 22/09/05

Queens Road, 14 06/01/05

Queens Road, 14 25/08/04

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 Queens Road, 14 Cowley Uxbridge Middlesex UB8 2NN Lead Inspector Mrs Rekha Bhardwa Unannounced Inspection 22nd February 2006 09:30 Queens Road, 14 DS0000027067.V273824.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 Queens Road, 14 DS0000027067.V273824.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. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Queens Road, 14 Address Cowley Uxbridge Middlesex UB8 2NN 01895 254925 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) Ealing Consortium Limited Miss Charlotte Barbara Dawson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: 14 Queens Road is a large detached two storey house situated in a quiet residential road in Cowley which is close to Uxbridge town centre. There are local shops and access to public transport close by. There is a front driveway with parking for several cars and a spacious enclosed garden at the rear, which is attractively laid to lawn with patio seating. The ground floor has a large communal lounge/dining room with doors leading to the garden. There is one bedroom on the ground floor, which has ensuite facilities. The kitchen, laundry, offices and cloakroom are also on the ground floor. There are four bedrooms on the first floor and two of these have en suite facilities. There is a further bedroom for staff to sleep-over and there is also an assisted bathroom and a further toilet on the first floor. The Registered Manager is supported by a team of one Senior and 7 ½ Careworkers. There are 12 vacant hours for flexibility. The staff team comprises two male and 5 ½ female Careworkers and the Service User group consists of 3 males and 2 females. The home is registered to care for five adults with learning disabilities whose ages vary from 19-55. There are currently three male and two female Service Users. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of 2.35hours was spent on the inspection process. The Inspector carried out a tour of the home, inspected service user plans, servicing records and staff records. The purpose of this inspection was to follow up the requirements from the last inspection, and to view some additional key standards. Several of key standards were viewed at the last inspection and it is recommended that this report be read in conjunction with the last report to gain full inspection information for the home. The Inspector met with two-service users on the day of the inspection, the Registered Manager, one Senior care staff and two care staff. One of the service users in the home communicates using makaton and also uses speech. Other service users in the home communicate through adapted signs, object of reference, photographs and symbols. A pre-inspection questionnaire completed by the Registered Manager has also been used to inform this inspection. What the service does well: What has improved since the last inspection? What they could do better: Further progress is required in the area of quality assurance. Health and safety issues in relation to the carpet on the first floor and service users toiletries must be addressed. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 6 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. Queens Road, 14 DS0000027067.V273824.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 Queens Road, 14 DS0000027067.V273824.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): None EVIDENCE: The key standard for this section was inspected at the last inspection and there were no shortfalls identified at that time. Queens Road, 14 DS0000027067.V273824.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 The service user plan documentation was comprehensive with evidence of individual reviews taking place. EVIDENCE: One service user plan was viewed during the course of the inspection. This contained details of the service users short term and long term goals. The care plans on mental health, personal care, social care, financial, cultural and religious needs, independence and medication. A review had been undertaken and covered all aspects of the service users plan. The records viewed contained details on decision making. This included decisions around personal care, having a front door key and the gender of staff providing care. At the time of the inspection none of the service users were able to manage their own finances. Any limitations on choice are agreed and recorded in the service users plan. A confidentiality policy is in place and all service users records are kept in the staff office, which is kept locked when not in use. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 10 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): 15,16 & 17 The home promotes positive relationships between service users and their families. Service users rights are respected by the staff and this enables the service users to have responsibilities within their capabilities. EVIDENCE: The Registered Manager reported that all the service users accommodated at the home have links with their families. This includes having contact with parents and siblings. Staff also support service users to visit family members outside of the home. One service user visits and stays with their family member for the weekend periodically. The Inspector observed the interaction between the staff on duty and the two service users within the home. This was professional and respectful. Staff have a good understanding of individual needs and enable service users to maintain existing skills and develop other independence skills. Any restrictions to choice are clearly recorded. None of the service users are able to go out unaccompanied. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 11 Since the last inspection the Registered Manager has developed some photocards to enable service users to participate in menu planning. Weekly meetings are held and service users are encouraged to participate in preparing the menu. The Registered Manager stated that not all service users chose to participate in these meetings. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 12 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 Service users preferences regarding personal care are recorded and followed, thus ensuring that the service users wishes are respected. Service users personal and health care needs are met and service users have access to healthcare professionals, thus ensuring that their healthcare needs are met. EVIDENCE: Each service user has a personal care needs assessment in place. Each area of personal care is clearly identified and the level of support and assistance that is required. Gender choice for personal care is recorded. Moving & handling and occupational therapist assessments are carried out and any specialist equipment required is identified and provided. There is involvement from the Consultant Psychiatrist at the local hospital. The home operates a key worker system to ensure continuity and consistency of care. Records viewed detailed involvement from the GP and other healthcare professionals. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 13 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): 23 The home has systems in place for the protection of vulnerable adults, thus safeguarding the service users. EVIDENCE: The Registered Manager reported that all staff had received training in the protection of vulnerable adults. Records of this training were available. The pre-inspection questionnaire detailed that there had been no POVA investigations. Due to the challenging nature of the service users all staff have received training in the management of challenging behaviour. Weekly staff meetings are held, during which reflection on practice sessions take place. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 14 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 standard of the environment within this home is generally good, providing service users with an attractive and homely place to live. Shortfalls identified should be easy to address. EVIDENCE: A tour of the premises was undertaken and service users individual bedrooms were viewed. Generally the premises were well maintained. All communal areas had been redecorated. The lounge and dining area had been redecorated since the last inspection and the carpet was to be replaced, with the Registered Manager in the process of obtaining quotes for this. The patio area had been re-laid to provide an even surface for service users to use. The garage and laundry area were viewed and are well maintained. The Registered Manager reported that key workers were working with individual service users on how bedrooms could be personalised. During the tour of the premises the Inspector found that the carpet outside the bedroom next to the sleep-in room presented a trip hazard, and this needs to be addressed. Flooring to the en-suite bathroom had been replaced and the broken ventilator in the outside kitchen wall had not been replaced. In one of the bathrooms it was evident that communal toiletries are in use. The importance of ensuring all service users have individual toiletries of their Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 15 choice was discussed with the Registered Manager. One service users E45 cream had been left in the bathroom. The home does not employ a cook or cleaner, these duties are undertaken by the care staff. Since the last inspection cleaning duties have been incorporated into the handover sheet and cleaning duties are allocated as part of the shift plan. On the day of the inspection the home was found to be clean. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 16 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 The staffing provision was appropriate to the meet the needs of the service users, thus providing them with appropriate care. The vetting and recruitment systems and practices are good thus safeguarding service users. EVIDENCE: There have been changes to the staffing levels since the last inspection. The Registered Manager reported that there is a minimum of two staff on the day shift. At night there is a sleep in person on duty. The employment records of one member of staff were viewed. These contained all the information as required in Schedule 2 of the Care Homes Regulations 2001. The home does not use any volunteers. The pre-inspection documentation detailed the training that had been undertaken by staff and the training that was planned. 40 of the staff team have achieved their NVQ Level 2 or above. Another 20 of the team are working towards their NVQ Level 2. Where staff are on their induction periods, these staff are working on their LDAF Units, which form the basis for NVQ knowledge. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 17 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): 38,39 & 42 The home does not regularly review aspects of its performance through a good programme of self-review and consultations. Work that has started in this area must be further developed in the best interests of the service users. Health and safety systems are in place and this protects the service users. EVIDENCE: A team away day was held for the staff in November 2005. The Registered Manager stated that she had developed a team centred plan. Work is underway with handover, shift leader responsibilities and roles and responsibilities. This standard will be examined in detail at the next inspection. The Registered Manager reported that since the last inspection feedback questionnaires had been sent to the service users and their families. The results of these questionnaires had yet to be collated. No further audits of the home had taken place. Further work is required in developing the quality assurance and quality monitoring systems. This standard will be viewed in detail at the next inspection. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 18 Servicing records were viewed at random by the Inspector and found to be satisfactory. The last fire drill was undertaken on 19/2/06. Further details on maintenance and servicing were recorded in the pre-inspection questionnaire. Individual risk assessments were available on individual service user files. Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 19 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 x x Standard No 22 23 Score x 3 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 2 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Queens Road, 14 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 2 x x 3 x DS0000027067.V273824.R01.S.doc Version 5.0 Page 20 YES 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 2 3 4 Standard YA24 YA24 YA30 YA39 Regulation 23(2)(p) 23(2)(b) 13(3) 24 Requirement A kitchen ventilator must be installed.(previous timescale of 6/1/06 not met) The carpet outside the sleep-in room must be made safe. Toiletries and creams must not be left in communal areas. A system of quality monitoring must be devised that includes feedback from a variety of relevant sources and uses the information to produce an overview with performance indicators. A copy of these outcomes must be sent to the CSCI. (partially addressed, previous timescale of 01/11/05 not met) Timescale for action 31/03/06 31/03/06 31/03/06 30/04/06 Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 21 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 Queens Road, 14 DS0000027067.V273824.R01.S.doc Version 5.0 Page 22 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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