Inspection on 11/04/05 for St Quintin Avenue, 1

This inspection was carried out on 11th April 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

St Quintin Avenue, 1 04/09/06

St Quintin Avenue, 1 04/11/04

St Quintin Avenue, 1 10/05/04

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 ST QUINTINS AVENUE 1 St Quintins Avenue North Kensington LONDON W10 6NX Lead Inspector Sheila Lycholit Announced 11 April 2005 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. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service St Quintin Avenue, 1 Address 1 St Quintins Avenue, North Kensington, London W10 6NX 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) 020 8968 3438 020 8968 3246 Look Ahead Housing & Care Mr Bimbo Sosanya Care Home 6 Category(ies) of Learning disability (6) registration, with number of places ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4 November 2004 Brief Description of the Service: The service is run by Look Ahead Housing and Care for 6 people with a learning disability. All of the service users have lived at 1 St Quintins Avenue for a number of years. The house, which is arranged over 4 floors, is spacious, with a pleasant garden leading off the lower ground floor. Most of the bedrooms, which are all single, are of above average size. The house is in a tree-lined avenue in North Kensington, close to shops, services and public transport. The service users, all of whom have high needs, attend day services in Kensington and Chelsea or Westminster. The building is not suitable for wheel-chair use, though the front entrance is ramped and one service user, who has restricted mobility, is able to manage the stairs to the lower ground floor. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector visited the home from 10.15AM to 4.15PM by appointment. The Manager and Deputy Manager were present throughout the inspection. In addition there were 2 staff on the AM shift and 3 on the PM shift. Two service users were at home on the day of the inspection. The other four service users returned from day services at about 3.30PM. The visit included a tour of the building. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 6 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 ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 7 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) 2,5 The home provides an individual service to each resident, based on an assessment, which is regularly reviewed. No new service users have been admitted for more than 2 years. EVIDENCE: The service is commissioned by the Royal Borough of Kensington and Chelsea and by Westminster Council. Each authority is responsible for 3 service users at the home. Three service users files were seen, as well as the essential information file, which contains the most recent person centred plans and service agreements for each resident, as well as contact details and information regarding personal care and medication. Records show that service users’ needs are regularly reviewed by the multi-professional team. An admission procedure is available, although no admissions have taken place for a number of years. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 8 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) 6,7,8 and 9 The staff team has taken steps to improve person centred planning and are developing ways of involving service users in making decisions and choices. EVIDENCE: Person centred plans are detailed and regularly reviewed. Monthly summaries review aspects of the plan, as well as describing events over the past month. Staff are making use of IT and multi media to support service users communication and to assist them in making decisions about their lives. The Deputy Manager takes responsibility for service user involvement and is part of the local quality network. Risk assessments are detailed and up to date. While none of the service users can go out unescorted, all take part in physical activities, which include trampolining, swimming and horse riding. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 9 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) 11,12,13,14,14,15 and 16 A more consistent approach to communication with service users, all of whom are non-verbal, has been adopted by the staff team. Day services and leisure activities are provided for each service user. Staff are seeking to expand the range of activities, venues and events available. A priority is given to maintaining relationships with families. EVIDENCE: The PC, which was purchased for service users, is now in use. All staff are learning the basic Makaton signs used by service users and staff have been booked on 2 further Makaton workshops. The Speech and Language Therapist continues to provide advice for staff in developing communication plans. Activity plans are available for all service users and are regularly monitored. Plans show that some service users have more access to external activities than others. The allocation of staff hours for activities ouside the home needs to be equitable, unless additional hours are commissioned. All service users attend day services on a number of weekdays. The day service has been suspended for one service user because of her very unsettled behaviour. The day centre provides a member of staff for her to have one to ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 10 one activities at home. Staff say that this is working well, though it is hoped that she will be able to reattend the service at some later date. Staff have taken service users on a number of holidays, which have been recorded on camera and by camcorder. Staff support contact with families by regular visits, telephone and by letter. A service user’s review recently took place at a parent’s home to support her involvement. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 11 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) 18,19,20 and 21 All service users need considerable support with their personal care. Excellent guidelines are available, indicating a detailed knowledge of each person’s needs, likes and dislikes. Action has successfully been taken to improve the administration of medication. The recent deterioration in the health of one service user has been well handled by staff, who have worked closely with health care colleagues. EVIDENCE: Each service user’s needs are clearly set out in his/her care guidelines. Health care needs are regularly reviewed by the specialist Nurse for people with a learning disability, who has also contributed to the care plan for the service user with a serious health condition. Records show that appropriate and speedy referrals are made for medical treatment. In 2 recent instances, staff have observed changes and quickly sought a medical opinion. None of the service users is able to hold their own medication. Training in medication has been provided by the Health Facilitator. The home has changed to the measured dosage system provided by a local Pharmacy. The MAR sheets are kept at the home on the PC and amended as necessary. Staff report that they find this system much easier to use and less likely to produce errors. A weekly count of medication is carried out. Skin creams and lotions are kept in a locked cupboard in service users’ bedrooms. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 12 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 and 23 The home has a complaints procedure, copies of which are available in the entrance hall. Complaints and concerns are responded to in a prompt manner. The staff team are aware of the vulnerability of service users and take steps to ensure their safety. EVIDENCE: Two concerns were noted in the complaints book since January 1st 2005, which the Manager had responded to quickly. Staff have received training in adult protection and copies of local policies and procedures are available. There have been 2 adult protection investigations in the past 12 months. Action has been taken to prevent a reoccurrence of an unexplained injury in one service user by installing additional grab rails in her bedroom, by the hatchway and in the corridors as recommended by the OT. The service user was observed to make use of these rails to move about the building. As a result of the other investigation staff ensure that any marks and bruising, however caused, are noted on body charts and have taken steps to improve communication with day services. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 13 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) 24,25,26,27,28,29 and 30 The building is in a good state of repair and was re-decorated in 2004. The house provides a pleasant, comfortable, domestic environment, with sufficient space for service users to pursue a range of activities, both with fellow residents and on their own. Specialist equipment has been installed on the advice of the OT to assist residents and staff and staff take steps to provide a safe setting for service users. EVIDENCE: Service users bedrooms are generally of above average size and each is decorated and furnished to reflect the taste and interests of the occupant. All bedrooms were seen during the inspection visit. The sensory room continues to be well used, particularly by one service user. A flat screen TV and audio equipment are available. Some new floor coverings have been fitted recently. The carpets in the hall and in the office are also in need of replacement. A new freezer has been purchased. The laundry is well equipped with heavy-duty machines that include a sluicing programme. The building was clean and tidy on the day of the inspection visit. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 14 The fluorescent light covers in the kitchen need to be cleaned more regularly. The garden and side entrance were clear of any debris or rubbish. Wire mesh has been placed over the bottom of a number of the sash windows to prevent a service user throwing items out. The Manager hopes that this is a temporary measure while her behaviour is unpredictable. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 15 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) 32,33,33,35 and 36 After an unsettled period with a number of staff changes, staff turnover has been substantially reduced and a more experienced and cohesive team established. Look Ahead Housing and Care has a comprehensive training programme, which provides induction, foundation and NVQ training for staff as well as a range of workshops. The Manager also encourages staff to take part in training offered by RBKC and Westminster Council. EVIDENCE: Three staff are expected to complete NVQ3 next month. As noted earlier in this report, only the Deputy Manager attended the Makaton course in the autumn but places on 2 other workshops have now been booked. Training records show that staff have attended a range of relevant training. One member of staff who has been in post for more than 6 months has yet to complete fire safety training. A system of staff supervision is in place. The supervision records of 2 staff were seen, which showed that supervision took place regularly and that issues discussed in supervision were recorded. Personal development profiles have been introduced by Look Ahead Housing Interviews for 2 vacant posts were taking place shortly. The Manager said that the advertisement had produced a very good response and he was hopeful of filling the posts. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 16 Staff records are held at Look Ahead Housing’s head office in Kensington and were not checked. The Manager does not see CRB checks, which are carried out by the HR Department. It is recommended that he be provided with the disclosure reference numbers to confirm that checks have taken place. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 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 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) 37,38,41,42 and 43 The Manager has taken steps to improve the management of the home and to introduce a more positive atmosphere. Ways of developing service user involvement are being introduced. Records are well kept and up to date. EVIDENCE: The Manager has been undertaking NVQ4/Registered Manager’s Award, which he expects to complete shortly. The Manager and Deputy Manager have access to a range of management workshops. The Deputy Manager, who has worked at the home for a number of years, was confirmed in post in January 2005. Two staff were interviewed during the inspection. Both reported that the team was more settled and that they both felt positive about developments at the home. Staff meetings take place weekly and are recorded. The Service Manager visits at least monthly. Reports of his visits are available in the home. Service user involvement is being developed both within the service and via the local quality network, of which the Deputy Manager is a member. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 18 Records seen were well kept. Service users files comprise a confidential file, a working file and detailed essential information held in a separate folder. It is recommended that the working file and confidential file be combined, with out of date information archived. Records show that fire alarm points are checked weekly in rotation. Fire safety systems and equipment are checked regularly. The fire safety risk assessment is up to date. Fridge, freezer and hot water temperatures are regularly checked and the water system is tested for Legionella. An annual health and safety audit takes place. Accidents and incidents are carefully recorded, with preventative action taken. CSCI has been notified of relevant incidents. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 ST QUINTINS AVENUE Score 3 Standard No 24 25 26 27 28 Score 2 3 3 3 3 Version 1.20 Page 19 G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc 7 8 9 10 LIFESTYLES 3 3 3 x Score 29 30 STAFFING 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 4 3 x Standard No 31 32 33 34 35 36 Score x 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 4 Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 3 3 ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 24 35 Regulation 231 18 Requirement Carpets in the hall and office need to be replaced within the next 6 months. All staff must receive fire safety training within 6 months of appointment. Timescale for action Oct 31 05 April 30 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. 2. 3. 4. Refer to Standard 24 34 41 14 Good Practice Recommendations Regular cleaning of the flourescent light covers neds to take place. The Manager should be provided with the CRB disclosure reference numbers for all staff employed at the home. Consideration should be given to the re-organisation of service users files. Staff should regularly review the activity programme to ensure that all service users have similar access to activities and leisure pursuits. ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 21 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26/28 Hammersmith Grove London W6 7SE 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 ST QUINTINS AVENUE G60-G09 S10848 ST QUINTIN AVENE AIV211947 110405 STAGE 4.doc Version 1.20 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!