Inspection on 13/12/05 for Star Road Respite Service

This inspection was carried out on 13th December 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 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

Star Road Respite Service 18/07/06

Star Road Respite Service 15/12/04

Star Road Respite Service 05/07/04

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 Star Road Respite Service 49 Star Road Isleworth Middlesex TW7 4HU Lead Inspector Ms Jane Collisson Unannounced Inspection 13th December 2005 3.00pm Star Road Respite Service DS0000034931.V270618.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 Star Road Respite Service DS0000034931.V270618.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. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Star Road Respite Service Address 49 Star Road Isleworth Middlesex TW7 4HU 0208 568 5133 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 Ms Stephanie Elaine Elvidge Care Home 7 Category(ies) of Learning disability (7), Physical disability (7) registration, with number of places Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Ealing Consortium be registered to carry on a care home for seven adults with learning and physical disabilities. 28th July 2005 Date of last inspection Brief Description of the Service: Star Road is a purpose-built seven-bedded short break service for service users with learning disabilities, who may also have physical disabilities. The home is managed by Ealing Consortium and the Dominion Housing Association (formerly Acton Housing Association) carry out the housing management. It is located off the London Road in Isleworth, where there are bus routes to Hounslow Town centre and Brentford. Approximately ninety service users each have up to thirty days annually for either short break stays in Star Road or other types of respite support. The service is funded by the London Borough of Hounslow, who make the referrals. The home is a single storey building, which has an adjoining supporting living scheme, also managed by Ealing Consortium, and an administration block. All have separate entrances. The home can be divided into two separate units, if required, of three and four bedrooms to provide for same gender stays or where smaller groups would be more appropriate. All of the bedrooms are single. There is one lounge/dining room, one lounge/games room, two kitchens and two bathrooms. Each unit has separate, enclosed gardens. The home was registered in March 2004 but not all of the bedrooms meet the National Minimum Standards for room sizes. They have been permitted because the service is for respite use only and all are over 10 sq. metres. There are two rooms suitable for wheelchair users and there is tracking for overhead hoists in some bedrooms and bathrooms. The majority of service users do not require these facilities and many are very physically able. The staff team consists of the Registered Manager, two senior support workers and a team of support workers, who are augmented by bank and agency staff. There is domestic assistance. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 13th December 2005 from 3pm until 7.20pm. The Registered Manager was present initially, with four of the staff team and eight service users, one of whom stayed only for the evening. The Registered Manager had shortly returned from four weeks’ sick leave and was organising the service users’ stays for the forthcoming year. A further visit was made on the 21st of December at 2pm to see staff records, as these could not be accessed at the first visit. Not all of the information was available but, as the Manager was on an extended holiday, it could not be discussed with her. The inspection took a total of five hours. The home had a relaxed atmosphere with the service users enjoying an evening meal, watching videos and favourite television programmes. All of the service users who were able to do so said that they enjoyed staying at Star Road. There were nine requirements at the inspection in July 2005 and have seven have been met. Two are partially restated and a further one have been made. For an assessment of all of the key standards, this report should be read in conjunction with the unannounced inspection report of 28th July 2005. What the service does well: What has improved since the last inspection? What they could do better: Medication brought in by service users’ families needs to be provided in the original packaging to minimise errors. To ensure that the families are aware of this, information should be provided in the home’s documentation. The heating system has been intermittently not been working in some of the bedrooms. Repairs have been carried out but independent heaters were being used at the time of this inspection in one bedroom. The Registered Providers must ensure that the Housing Association repairs, or replaces, the heating system and ensure that it is maintained in good order. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 6 Staff records were left for inspection while the Registered Manager on holiday and not all of the information which is required to be held for staff, such as details of their Criminal Records Bureau disclosures, was available. Records must contain all of the information required under Schedule 2 and 4 of the Care Home Regulations 2001. 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. Star Road Respite Service DS0000034931.V270618.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 Star Road Respite Service DS0000034931.V270618.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, 2, 3, 4, 5 Prospective service users are given information about the home and its services. They have the opportunity to visit in advance, and acquaint themselves with the service, so that they feel confident about staying overnight. EVIDENCE: The Service Users Guide and the Statement of Purpose are in place. The Statement of Purpose provides the service user and their families with information about the service and if their specialised needs can be met. However, the short guide, which is given to new service users, does not include information about the medication procedures which are required and this should be included. Service users are able to visit the home for short visits, usually during the early evening, to introduce them to the service and ensure that they have sufficient confidence to stay overnight. Records of the visits are made and a sample of these was seen. An assessment is undertaken from which care plans and risk assessments are produced. Information on the service users’ likes and dislikes and preferred support was seen in the files examined. One service user was being accommodated for short periods, but not staying overnight, following an accident to the service user’s family member. Service users have up to thirty overnight stays a year which can be taken in varying periods, ranging from one night to up to three weeks. All continue to Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 9 attend their usual day centres and colleges and the service provides an opportunity for them to meet other people and have time away from their families. The care plans and notes of visits that were examined showed that service users have the opportunity to either carry on the pursuits they enjoy, such as watching videos, but also to enjoy activities outside of the home and perhaps try new activities. There is no contract/terms and conditions because of the nature of the service provided. A small daily charge is made for each overnight stay and this is detailed in the short guide. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 10 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, 10 The service is able to provide short breaks for service users with a variety of care needs, from those who are very independent to others with more complex needs. Progress has been made on providing care plans and risk assessments to cover all of the needs of the service users. EVIDENCE: Three of the care plans were examined of service users who were staying in the home during this inspection. The care plans showed that their individual needs had been considered. Likes, dislikes and background information is included, plus any specialised support that they may require. Additional care plan for support required during the night have been produced. Some of the care plans have now been individualised with photographs and pictures, but contain the information to assist all of the staff, some of whom may not have met the service user, to understand the care and support required. All of the service users are given the opportunity to make decisions and those in the home on the evening of the first visit of the inspection had made choices about the activities they were undertaking. These included watching television and a video, relaxing or staying in their bedrooms. Although a specific meal Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 11 had been planned for the evening the service users, when asked, exercised their choice and a variety of different meals were provided. None of the service users on this inspection had mobility needs, but two service users had mainly non-verbal communication. One staff member showed a particularly good awareness of the needs of one service user who communicates non-verbally. Two of the service users are very independent and one had been to visit his former school during the day, travelling alone to do so. Arrangements were seen in the care plan for contact to be made by mobile phone when the service user is travelling independently. Risk assessments have been improved and the care planning files also contained information on any restrictions that are agreed. These included the use of equipment, such as bedsides. For those service users with a higher level of needs, one-to-one support is provided with extra funding from the Community Team for People with Learning Disabilities. Service users’ information is kept confidentially within the home. Notes made during the service users’ stays in the home are shared with their families. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 16, 17 The service provides service users with the opportunity to spend time away from their families, enjoying activities and meeting with friends in a different environment. EVIDENCE: All of the service users continue to participate in their usual day activities, which may include day centres and college courses. Two of the service users indicated the importance of the day services to them. The activities available in the home include outings within the community and a minibus is available for use when a driver is on shift. Notes are made of the activities that the service users have enjoyed and these included the cinema, bowling and aromatherapy. The service users have the opportunity to exercise their rights by being encouraged to make decisions. During this inspection, service users showed that they felt comfortable in moving around the home and undertaking the activities they enjoyed, in the way they preferred. This included spending time in their own rooms. Any restrictions placed upon them are detailed in their care plans. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 13 Although a meal had been planned for the evening, a number of service users decided that they would like different meals and the staff provided fish, pizza, chips, mashed potatoes, baked beans and coleslaw from which to choose. A choice of desserts was available. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 14 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 Although the service users’ families retain responsibility for the service users medical and health needs, information is kept should emergency treatment be required. The service users are supported with their personal care where needed. EVIDENCE: Support with personal care is given as required and agreed in the service users’ care plans. There are two assisted bathrooms and suitable equipment to bathe service users with high mobility needs. There had been a small number of complaints from relatives regarding personal care, which the Registered Manager has dealt with. The health needs of the service users are generally met by the families, except in the case of an emergency arising. Details of the service user’s General Practitioner are included in the file. It was noted in the files examined that staff had contacted the family members where service users had displayed some emotional behaviour, which may have been distressing, to see if it could be alleviated. Service users’ families provide the service with the medication that is required for each service user and the amounts of tablets and other medication are recorded when the service user is admitted. One service user’s family had Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 15 provided medication in a “dosette” box which had not been filled by a pharmacist. Medication should be brought to the home to be dispensed from the original containers, to minimise the risk of errors. Families need to be made aware of this and the information should be included in the guide which is provided to service users and their families. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 16 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 The service users who were met during this inspection were able to make their wishes known, both vocally and non-verbally. Service users’ families are able to make their concerns known, either through the complaints procedure, or by bringing their concerns to the regular meetings held for carers. EVIDENCE: There had been three complaints made since the last inspection in July 2005. Two concerned problems with personal care and one with staff attitude. In one case, guidance and a checklist had been put in place to try and improve the situation for the service user. The Registered Manager was seen to have replied to the other service user’s family appropriately. Because of the Registered Manager’s absence, the carers’ meetings had not been held so regularly, but these do provide for families to express their views on the service. No adult protection issues have been raised in the last year. Staff have now had safeguarding adults’ training. Service users bring only small amount of money into the home, for the activities they undertake, and record books are kept, with receipts, for money managed by the home. A sample of these was seen. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 17 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 home was found to be comfortable and bright, with Christmas decorations adding to the cheerful atmosphere on this occasion. EVIDENCE: The home can be divided into two smaller units, one with three bedrooms and one with four. Each has its own lounge and kitchen. However, on most visits to the home since its refurbishment in 2004, the service users have shown a preference for using the main lounge, which is a busy area, or be in the bedrooms watching television individually. The lounge has a large dining table which service users also use for carrying out activities and games. Both of the lounges have small gardens attached. Because the home was refurbished less than two years ago, there are no environment refurbishments required at the current time. However, there have been problems with the heating system and two of the bedroom radiators have not been working when visits were made by the Registered Provider’s representative. One was not working at the time of this inspection. Mobile heating is been used, as a back-up system, and risk assessments were in place for each of the service users should this heating be required in their room. The Registered Providers must ensure that the Housing Association repairs or Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 18 replaces the heating systems in the bedroom affected so that the home’s heating can be used at all times, particularly during this winter. Because the bedrooms are not used on a permanent basis, they contain the basic items required for the stay, including television and stereo equipment. All rooms have wash hand basins. Service users are able to bring in items, such as videos and music, from home if they wish. The rooms are pleasantly furnished. Two of the bedrooms have overhead hoist tracking. The bathrooms also have assisted facilities to provide for service users with higher mobility needs. There is a cleaner employed, who was on sick leave during this inspection. However, the home was found to be well maintained and cleaned by the care staff. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 19 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): 31, 34, 36 The staff team met on this inspection were enthusiastic about the support they can provide to the service users to enjoy their stays in the short break service. EVIDENCE: Although there is a permanent staff team, with two senior support workers, there were bank and agency staff being used during this inspection to cover for a number of staff on sick leave. The agency and bank staff tend to be regular staff who are aware of the needs of the service users. The care plans in place have sufficient information for staff to understand the care needs of the service users and it was noted that they have to sign the care files of the service users to say that they have read them. One senior has been on long-term sick leave. The Registered Manager had also been on sick leave for some weeks and was in the process of bringing staff supervisions up to date. A sample of the staff records was seen. Although most of the information was in place, there were some items which needed clarification and no information was available on the Criminal Records Bureau disclosures for the staff. The Registered Manager was not available for four weeks, following the second visit to the home, so the information could not be clarified. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 40, 41, 42, Progress has been made in meeting the requirements of the last inspection with regard to record keeping. The service users benefit from an organised service. EVIDENCE: During this inspection, the Registered Manager was in the process of organising the short breaks for the service users for the forthcoming year. This was in conjunction with the respite coordinator from the Community Team for People with Learning Disabilities. A good level of organisation is required as there are up to seven service users, plus those on preliminary visits, to accommodate on most nights. The Registered Manager said that, where there are cancellations, the staff try to arrange for another service user to use the vacancy. The occupancy rate has varied between 83 and 93 in the last three months. Ealing Consortium are still in the process of updating some of the policies and procedures, although progress is being made with this. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 21 The records examined were seen to be kept in good order. Those examined included those for service users, staff, fire precautions, training and meals. There were no outstanding health and safety issues except the bedroom heaters, which have not working periodically, and need to be repaired and maintained in working order. The Registered Manager said there were no other outstanding maintenance issues at this time. The financial records were not examined on this inspection. Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X X 2 X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Star Road Respite Service Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X 3 3 2 x DS0000034931.V270618.R01.S.doc Version 5.0 Page 23 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 Standard YA1 Regulation 13 (2) Requirement Timescale for action 31/01/06 2 YA24 YA42 23 (2) (c) (p) 3 YA34 17 (2) Sch. 4 (6) Medication brought to the home must be in the original containers and service users’ representatives must be aware of these arrangements for bringing medication to the home. The Registered Providers must 28/02/06 ensure that the Housing Association repairs, or replaces, the heating system to ensure that it is maintained in good working order. (The previous timescale of 31/8/05 not fully met). All of the information that is 28/02/06 required to be held for staff, such as details of their Criminal Records Bureau disclosures, must be available for inspection. (The previous timescale of 30/9/05 not fully met 30/9/05). Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 24 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 Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI Star Road Respite Service DS0000034931.V270618.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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