Inspection on 10/05/06 for Striving For Independence Group

This inspection was carried out on 10th May 2006.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Striving For Independence Group 02/08/07

Striving For Independence Group 04/11/05

Striving For Independence Group 26/05/05

Striving For Independence Group 20/01/05

Striving For Independence Group 22/07/04

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 Striving For Independence Group 3 Pettsgrove Avenue Wembley Middlesex HA0 3AF Lead Inspector Richard Adkin Unannounced Inspection 10th May 2006 08:00 Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 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 Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 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. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Striving For Independence Group Address 3 Pettsgrove Avenue Wembley Middlesex HA0 3AF 020 8795 1586 020 8900 9633 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) Striving For Independence Group Homes Mr Otis Pinnock Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th November 2005 Brief Description of the Service: Pettsgrove is one of three homes run by Striving for Independence, a family run organisation that provides care and accommodation for adults with a range of learning disabilities and challenging behaviours. Pettsgrove provides care for 6 adults of both genders. There is a self-contained day centre in the grounds, which is used by the homes residents as well as service users from other homes in the area. The house is detached and situated in a quiet residential road in Sudbury close to local shops and transport to Harrow and Wembley. Accommodation is provided on two floors with single bedrooms and bathing and toilet facilities on each floor. There is a spacious lounge in the ground floor as well as large kitchen/ dining room and utility room. A well-kept garden is to the rear of the home. There is parking for up to 5 vehicles on the driveway as well as parking on the road. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over 5½ hours midweek one early morning in May, with the focus of looking at key standards. The Inspector had the opportunity to meet the sleeping in and waking member of staff; the Proprietor kindly made herself available and the manager came on duty during the course of the inspection. The Inspector had the opportunity to meet all the residents at the care home and make a tour of the care home and looked at care records and policies and procedures. The Inspector would like to thank the residents, staff and manager for their contribution to the inspection. What the service does well: What has improved since the last inspection? What they could do better: It still remains outstanding for amendments to take place on the home’s policy and procedure for handling resident’s finances that reflect the changes in the payment of benefits. Details of the care worker giving medication, including signed initials, medication training must be kept in the administering of medication folder. The number of notices displayed in the dining area mainly directed towards staff are intrusive to the residents’ environment. Some incidents and accidents have not been recorded and this needs to happen systematically and fully. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 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. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 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 Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The Service User Guide gives clear accessible guidance as to how residents’ needs will be met. EVIDENCE: Speaking to the staff on duty and looking at records, it was evident that it was an established group of residents living at the care home. The most recent resident had been at the home for over two years, the main group of residents had been at the home for 10 years. The Service User Guide is pictorially accessible and user friendly; it addresses, facilities, accommodation, day activities, how to apply what happens when you come to the home and how the needs of the individual residents are met and that meeting these needs is a core function of the care home. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed and reviewed and realistic goals are set. EVIDENCE: Each resident has a risk assessment form. This was looked at by the Inspector for two residents, covering the likelihood of the risk, the severity of the hazard, risk provoking factors and action that needed to be taken to reduce risk whilst balancing and promoting the independent needs of residents. Reviews take place yearly with six monthly updates. At the yearly review, care managers from the sponsoring local authority attend and contribute to these meetings along with the resident. Detailed Personal Planning Programmes are in place for each resident with an action plan with short, medium and long term goals. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 10 Identified needs are detailed on a separate form with the level of support needed or provided to promote choice and independence. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents have access to and take part in appropriate activities. Choice is offered for food provided. EVIDENCE: On the day of the inspection it was planned for most of the residents to go out for lunch, to the park and shopping, as is the practice on Wednesdays at the care home. One of the residents was going to college (computer skills at North West London College). Another of the two residents was collected by transport to go to Strathcona Day Centre during the inspection. The care home has its own new purpose built day room, which has good facilities including IT screens and is used regularly by the residents. Though the Inspector visited early in the morning, all the residents had had breakfast except for one resident who had a sandwich and fruit in front of her. Some residents had cooked breakfast on request. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 12 The menu was on display, which is a four-week menu, with a column for alterations actually made to the menu. The food offered is a varied choice. Meals eaten by residents are recorded fairly regularly, though it would be helpful to have a picture of full days food eaten. Three residents particularly have contact with their families. Residents have friends and family members who are invited to events at the home. Three residents had been on a trip to Orlando for two weeks in March 2006 and this had clearly been a successful trip. It was planned for the other residents who did not go on this trip to go to Butlins and Centre Parcs in July for a holiday. Three residents have joined and use the local library regularly. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The health needs of residents are addressed. Medication procedures need improving. EVIDENCE: The Inspector looked at the health files of residents. Appointments were up to date for records looked at for residents attending chiropodist, optician, dentist, GP and psychiatry and so on. Positive interaction was observed between residents and care staff at the care home during the course of the inspection and support was observed in supporting residents to toilet and self care. The Inspector looked at the medication policy. This was revised in December 2004 and is kept in the medication policy file, as well as the operational policy book. No residents self medicate at the care home. There is a summary sheet with the MAR sheets that details GP diagnosis, medication and allergies. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 14 The folder did not contain a list of care workers giving medication or their signed initials and date of medication training, which should be rectified for clarity and to help establish an audit trail. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 15 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 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The procedure on handling residents’ finances must be finalised to protect residents. Residents’ views are listened to. EVIDENCE: At the previous inspection a statutory requirement arose that the homes policy and procedure for handling residents finances must be amended to reflect the changes in the payments of benefits. The Manager informed the Inspector that he was currently working on this document, but had yet to finalise it. The complaints policy for the home is in a user-friendly form, as well as a comprehensive complaints policy statement. There have been no POVA incidents since the last inspection. The home has a range of policies for the protection of service users, such as bullying, service user’s money and gifts, an abuse policy, service users’ financial affairs and so on. The home has the Brent POVA guidelines available and the POVA policies for the boroughs where the residents originate. Residents meetings are taking place with a monthly schedule for the year, and are on display in the dining room. The Inspector looked at minutes. One resident takes a particularly central role in these meetings. It would be helpful if this was collated and made accessible to residents. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 16 Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 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, 27, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Residents’ live in a comfortable clean environment. The home would be more homely without a number of intrusive notices. EVIDENCE: The home feels comfortable and homely with the reservation that in the kitchen/dining area there were over 45 notices on display, a number of which were not on the notice board, mainly for the attention of staff. The information should be organised with a section for residents. The notices and instructions for staff must be less intrusive and reduced considerably. The Proprietor said this was an effective means of communication, and a member of staff said that she does read these notices. However, overall the notices give a poor impression. The quality of the environment and fabric of the building is good, with wellmaintained accessible gardens where residents contribute to the maintenance of the garden and use it for their enjoyment. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 18 Given that several residents have continence issues, the home was free of offensive odours and was clean and tidy throughout. One minor improvement to the physical environment was noted during the course of the inspection. A blind or curtain is needed in the downstairs toilet to provide privacy as the side path leading to the front drive overlooks it. Whilst the inspection was taking place the front boundary fence was being weatherproofed. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 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): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents are supported by competent and trained staff and are protected by the home’s recruitment practices. EVIDENCE: The staff meeting schedule is displayed. Meetings take place fortnightly. Monthly there is a training topic, including First Aid, Health and Safety awareness, petty cash and service user care. Minutes are recorded for the staff meeting and staff are actively encouraged to attend. Each staff member receives a copy of the minutes. The Manager kindly provided a training profile for the home with outcomes and evaluation measures. Two staff files were looked at by the Inspector. These included relevant documents such as CRB checks, references, birth certificates, induction records and training undertaken by the care workers. Information was not readily available about NVQ training for members of staff and this should be passed through to the Inspector to ensure that a planned Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 20 programme of training was being fully implemented. Evidence of staff having been on training courses was seen by the Inspector on staff members’ records. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 21 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, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Incidents and accidents that occur must be recorded to protect residents. The Proprietor carefully monitors the progress of the home. EVIDENCE: A requirement from the previous inspection was that the Proprietor must carry out monthly Regulation 26 visits to the home – copies of these visits must be sent to the Commission for Social Care Inspection. The Proprietor has sent reports through to the CSCI for March and April 2006. The Inspector looked at the report for March, which was comprehensive. It was evident from speaking to the Proprietor that she wanted to improve on standards throughout the organisation. 15 accidents were reported for the first nine months of 2005, but no incidents/accidents have subsequently been recorded, i.e. for the last 7 – 8 months. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 22 Looking through the daily logs that are comprehensively kept for each resident, with three reasonably detailed entries per day made systematically for each resident, by staff on duty. However, there was the odd entry in these records, which should have been recorded as an accident, or incident that has taken place and this has been acted upon to avoid further accidents or incidents. The last internal check of fire alarm doors, emergency lighting, emergency exits, fire blankets and the fire extinguisher took place on 8/5/06. This is a monthly check and includes a fire drill with observation of how it went. The yearly inspection happened on 1/9/05. The portable appliances were tested on 7/3/06. Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 23 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 Standard No Score 1 X 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X X 2 X Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 24 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 YA20 Regulation 13(2) Requirement Details of the care worker giving medication, including signed initials, medication training must be kept in the administering of medication folder. The home’s policy and procedure for handling residents’ finances must be amended to reflect the changes in the payment of benefits. (Previous timescales of 6/12/05 and 1/5/05 not met) A reduction must be made to the amount of notices that are displayed in the dining area. Screening is needed in the downstairs toilet to provide privacy. Incidents and accidents must be recorded in the accident book and acted upon. Timescale for action 01/08/06 2. YA23 20 01/07/06 3. 4. 5. YA24 YA27 YA42 12(4)(a) 12(4)(a) 17(1)(a) 01/07/06 01/07/06 10/05/06 Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 25 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 Striving For Independence Group DS0000017477.V292026.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 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. 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