Inspection on 20/09/05 for RNID

This inspection was carried out on 20th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

RNID 02/12/08

RNID 20/02/07

RNID 22/02/06

RNID 27/01/05

RNID 09/09/04

Similar services:

Foxley Lane (121a)

Avenues (The) (Neave Crescent)

Banstead Road South (21)

Rela Goldhill Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 RNID 113 Brondesbury Road Kilburn London NW6 6RY Lead Inspector Sue Mitchell Announced 20 September 2005 10:30 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 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 Stationary 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. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service RNID Address 133 Brondesbury Road Kilburn London NW9 6RY 020 7328 8540 020 8372 8965 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) RNID CRH - Care Home 6 Category(ies) of SI - Sensory Impairment registration, with number of places RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Accommodation and personal care for 6 Younger adults aged 18 -65 Date of last inspection 27/01/05 Brief Description of the Service: 113 Brondesbury Road is care home run by the RNID and provides supportand accommodation for 6 residents who are hearing impaired, some with additional sensory impairments. The staff are also trained to support additional needs that include visual impairment, mental health issues, mild physical disabilities and learning disabilities. The house is located in Kilburn and is close to local shops, tube and bus routes. The house is a modernised semi detached property in a quiet residential area. The accommodation is on three floors with the communal rooms being on the ground floor. There is no wheelchair access. There are 6 single rooms with bathroom and toilet facilities on each floor. There is a small well kept garden to the rear of the house with a patio area and barbecue for the residents use.. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector made two visits to the home. One was in September to carry out an inspection of the paperwork, assess standards and to meet with the staff. The second visit was in October with a hands-on signer and interpreter so that the residents and any hearing impaired staff could have the opportunity to talk to the inspector personally. The inspector met with four residents and one staff member on that day. The inspector met with the staff on duty on both days and discussed their role in the home and their relationships with the residents. The inspection focussed on following up the requirements of the last inspection, care planning and reviews, risk assessments, medication, complaints, premises, staffing, training, and health and safety matters. The manager and her team were very helpful and informative throughout the inspection process. What the service does well: What has improved since the last inspection? What they could do better: RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 6 Seven requirements were set at this inspection. One was outstanding from the last inspection when premises risk assessments were required. The manager must ensure that the medication policy includes a policy on homely remedies and contacts the pharmacist to renew their contract. The lounge needs to be redecorated and new washable flooring for the dining area was required. The resident’s personal electrical equipment had not been tested at the last Portable Appliances testing and must be arranged. The Housing Association must be contacted to supply missing certificates for the recent gas service and legionella tests. There were three good practice recommendations made. Staff are recommended to compile a care plan folder for each resident so that up to date information is more accessible. Some of the residents have a mild learning disability and is recommended that training on understanding learning disability and challenging behaviour is included in the training programme. There had been a Health and Safety audit carried out in February 2005, it is recommended that the manager check with the service manager whether the action plan has been implemented in full. 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. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 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 standard(s) 2 Residents’ needs are reassessed as part of the home’s regular reviewing process EVIDENCE: The residents have lived together in the home for number of years. Some have been there since the home first opened. There have been few changes to their needs during this period. One person had expressed a wish to move on to more independent accommodation at the last inspection to the inspector. The inspector was informed that this is being addressed by the placing authority that are looking for another placement for this person. Another person had been referred to SENSE for an assessment to be provided with a deaf/blind stick following a serious accident in the community. The care files sampled indicated that the residents’ every day wishes and needs were addressed as part of the home’s normal care planning and reviewing process. One resident had recently turned 65. The manager was advised that an application to vary the homes registration to accommodate this person was now required. A form was sent to the manager following this inspection. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 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 standard(s) 6,7,9 Residents are supported to participate in their care reviews and make their own decisions about how they wish to live their lives. They have the opportunity to participate in and contribute to the day-to-day running of the home. Residents are able to make decisions about their day-to-day living needs and wishes as well as to plan for their future EVIDENCE: Two care folders were sampled. These contained two files with both old and recent information on the residents. Care plans were in place for both people with action plans and goals set for the residents to achieve. Recent reviews indicated that the residents attended their meetings with an interpreter to support them to participate in the review. Action plans were in place, which identified the individual’s wishes and goals. Key workers have one to one sessions with the residents, which are also recorded. Monthly summaries and daily records are also kept. Risk assessments were in place for each person. These reflected the potential risks for the residents for in house and community activities. These were noted to have been updated but old copies of assessments were also on the files. It is strongly recommended that the key workers review the care files and create a working care plan folder where only current or ongoing information is kept such as recent reviews, care plans, risk assessments, current medical/ health care information, health care RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 10 records, recent monthly summaries etc. Some information, which would be useful, was kept in the “old” file. New staff would find it helpful to be able to access current information. This was discussed with the manager in some detail. The inspector met with four residents who communicated with her through an interpreter. The residents were very positive about the support they received from staff to participate in the local community and to access services. The residents have a regular community meeting where they discuss menus and plan activities and holidays. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 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 standard(s) 12,13, The residents are supported to participate in activities of their choice both in house and within the local community. EVIDENCE: The two care files sampled indicated that the residents are given the opportunity to lead an independent lifestyle both within the home and out in the community. Some people need a little support to attend activities but others are able to go out independently. The residents had enjoyed a holiday together in the Isle of Wight. They were very positive in the discussion with the interpreter and inspector about the holiday and described the activities they had done such as swimming and going to the pub etc. One person said he had gone to Malta to visit family, which he enjoyed very much and another had attended two camps with a local club. One person’s review indicated that he had chosen to go to Disneyland Paris for his next holiday. Two residents go to the gym regularly and one swims five times a week. One person cycles round the local area. Others go out daily to the shops or further afield on their own. Two people attend the local day centre, one full time and one part time. Both people said they liked going to the centre and enjoyed the activities there. One person had requested to go to the day centre but there had been RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 12 some delay in achieving this but staff were hopeful that this would happen shortly. One person goes to college one day per week for courses in English, maths and computers. He is supported by an interpreter to attend the college. The residents use the local shops, pubs, and restaurants, parks and sports facilities independently as much as possible. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 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 standard(s) 19,20 The residents are supported to access local health care facilities independently. The home’s medication policy protects and assists the residents in taking their medication EVIDENCE: There were detailed records of all health care appointments on the two files sampled. There were also records of regular hospital appointments with outcomes of each visit in one person’s file. As detailed in Standard 6 it is recommended that current medical information etc should be kept on the working care plan folder rather than being archived. One person is visited every three months by the Community Psychiatric Nurse. There was a record of a recent CPA meeting on this person’s file. The home had met the requirements regarding medication from the last inspection. The medication policy needs to include a homely remedies policy. The contract with the local pharmacist had expired on 31/3/05; the manager must ensure this is renewed. The staff are due to attend medication training, which is a 12 week distance learning course. The medication records were sampled and found to be correct for the day’s medication. None of the residents is self- medicating at present. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 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 standard(s) 22 The residents are aware of how to raise complaints and concerns. EVIDENCE: The home had complied with the requirements and recommendations relating to this standard. There is a resident’s complaints policy in place. The manager stated that she had met with the residents and an interpreter to discuss the complaints policy with them when she first came to the home. One person had made a complaint since the last inspection. This had been recorded and resolved in house. None of the residents had any complaints or issues to raise with the inspector. They stated that they were happy living in the home and that staff were very helpful. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 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 standard(s) 24,28 The residents live in a comfortable and homely environment, which would benefit from some redecoration and refurbishment. EVIDENCE: The inspector toured the communal areas and one resident showed her his bedroom. The manager stated that she had carried out an audit of the premises regarding refurbishment and redecoration that was needed. The lounge was showing signs of wear and tear and had not been decorated for some time. The dining room carpet was badly stained and must be replaced with more appropriate washable flooring. The home has applied for funding to provide an extension to the rear of the house. This is still ongoing and the manager was not sure when this would be agreed with the housing association. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,35 The residents are supported by an experienced and well trained staff team. EVIDENCE: The acting manager is covering the post during the present manager’s maternity leave. Staffing has improved since the last inspection with the appointment of a deputy and another support worker. There is one vacancy at present, which has not yet been advertised. The personnel files for the two new staff were made available for inspection. These contained all the other checks required. The home is waiting for a CRB check for the new deputy. The staff rota indicated that there were a minimum of two staff on duty up to 8pm. The residents are quite independent and at present do not need two staff on duty all evening as they lead their own lives, going out into the community or staying in their rooms. This was discussed with the manager who said this situation was being monitored regarding staff and residents vulnerability. An on call system is in place and staff have access to the manager via text /telephone and Mincom. Extra staff would be rota’d if residents wish to attend an activity in the community in the evenings and require support or transport. The residents and staff benefit from having two staff that are hearing impaired and are able to communicate with the residents directly. Staff have also had training in BSL and have learnt fingerspelling to assist them in communicating with the residents. An interpreter is used for the monthly staff meetings and supervision for the hearing impaired staff. Staff RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 17 meetings are held monthly. The inspector was informed that the RNID runs a national training programme for staff to access. Information on courses is circulated by email and the manager identifies training for staff. Recent training has included fire safety, first aid, deaf/blind awareness, mental health/ schizophrenia, deaf and disability awareness and Start to Sign. Risk assessment, POVA training and medication were scheduled for September 2005. One staff member has completed NVQ3 and one is due to start this course. Staff confirmed that they have had regular and good training and have appreciated the training on deaf awareness and signing. They also stated that they were being well supported by the manager and acting deputy. One person said that some of the residents have some learning disabilities and challenging behaviour because of this and that training in this area would be helpful. This is recommended. The inspector spoke with a member of staff who is hearing impaired. This person said that the RNID have supported him in his work by providing equipment, note takers and interpreters to assist him in carrying his out his work in the home and when on training courses. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The residents’ health, safety and welfare is protected through the homes robust policies and procedures and regular checks of appliances used in the home. EVIDENCE: Certificates relating to the equipment and appliances used in the home were made available for inspection. The recent portable appliance tests had not included the equipment in the resident’s rooms. This is required. The gas and legionella test certificates were still held by the housing association. The manager must ensure that these certificates are kept in the home. The fire brigade had visited the home in September 2005 and a number of requirements relating to the premises and record keeping had been made. The manager stated that the housing association were in the process of carrying out the premises requirements. The home had complied with the record keeping requirements. Weekly call bell tests and fire drills are carried out and recorded. A health and safety audit had been carried out by the previous manager and service manager in February 2005. The acting manager RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 19 was unsure how much of the work identified had been carried out. She was advised to discuss this with the service manager at his next visit. The home had been required to carry out a premises risk assessment; this had not yet been achieved. The manager stated that she was due to attend risk assessment training and would carry out the assessments. The manager carries out a monthly audit of accidents and incidents. The home is prompt in informing CSCI of any significant events. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 20 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 2 x x Standard No 11 12 13 14 15 16 17 x 3 3 x x x x Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 RNID Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 21 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. 5. 6. 7. Standard 20 20 28 28 42 42 24 Regulation 13 13 23 23 13 Requirement The medication policy needs to include a homely remedies policy. The manager must ensure that the contract with the local pharmacist is renewed The lounge must be redecorated The dining room carpet must be replaced with more appropriate washable flooring The residents portable appliances must be tested. The gas and legionella test certificates must be in the home. Premises risk assessmentsmust be carried out (previous timescale of 31/3/05 not met) Timescale for action 31/10/05 31/10/05 30/11/05 30/11/05 31/10/05 31/10/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations It is strongly recommended that the key workers review the care files and create a working care plan folder where only current or ongoing information is kept such as recent reviews, care plan, risk assessments, current medical/ G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 22 RNID 2. 3. 35 42 health care information, health care records, recent monthly summaries etc. It is recommended that training on understanding learning disability and challenging behaviour be included in the staff training programme The manager is advised to discuss the progress on the action plan from the health and safety audit carried out in February 2005 with the service manager at his next visit. RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Aspect Gate, 4th Floor 166 College Road Harrow HA1 1BH 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 RNID G62 - G11 S17431 Brondesbury Rd V243400 20.09.05 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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