Inspection on 02/08/07 for Striving For Independence Group

This inspection was carried out on 2nd August 2007.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Striving For Independence Group 10/05/06

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 Andreas Schwarz Key Unannounced Inspection 2nd August 2007 09:30 Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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.V337160.R01.S.doc Version 5.2 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.V337160.R01.S.doc Version 5.2 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.V337160.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 2006 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. Fees and Charges can be obtained on request from the registered provider. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place in August 2007 and lasted seven hours. The registered provider Mrs Dorothy Pinnock, the registered manager Mr Otis Pinnock, Mrs Deborah Pinnock and a senior support worker was available to support the inspector. I viewed three care plans, observed staff interacting with people using the service, spoke to one person using the service and spoke to three members of staff. I viewed a range of files and documents relevant to make a judgement about the quality of care. The home forwarded a completed Annual Quality Assurance Assessment within the given timescale to the Commission for Social Care Inspection. I would like to take this opportunity thanking people using the service, staff registered provider and registered manager for supporting the inspection process. What the service does well: What has improved since the last inspection? Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 6 The home has met all requirements made during the last inspection and is regularly informing the Commission for Social Care Inspection of any notifiable incidences. What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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.V337160.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. A skilled and experienced member of staff always undertakes assessments. EVIDENCE: The current group of people using the service has not changed since 2002; previous inspections demonstrated that assessments have been undertaken to good standard. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. Staff understands the importance of residents being supported to take control of their own lives. The care plans are person centred and are agreed with the individual. Management of risk is positive addressing safety issues whilst aiming for better quality of life. EVIDENCE: I viewed three care plans during this unannounced key inspection. Care plans have been reviewed regularly and people using the service have been involved within the review process. Care plans are based on encouraging and teaching people using the service new skills. I viewed individual guidelines in one of the peoples files, it was however not fully clear how the home is monitoring the persons progress and I suggested to design a monitoring chart for staff to record the persons participation in this programme. During the day of this inspection a care manager visited to undertake a placement review on one of Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 10 the person using the service. Care plans address short/mid and long-term goals. I observed people using the service relaxing in the lounge. People’s choices and likes are recorded in care plans. Where there is the level of risk to high the home is providing detailed risk assessments with guidance to staff. People using the service have access to independent advocacy. For people who can be challenging at times, I viewed detailed behaviour guidelines. The home is planning to audit people using the service accounts externally. Risk assessments are of good standard and regular review is evident. I viewed a range of general risk assessments in regards to flooding of the premise, fire, kitchen safety, etc. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. The service has a strong commitment to enabling people who use services to develop their skills, including social, emotional, communication, and independent living skills. Individuals are supported to identify their goals, and work to achieve them. Meals are very well balanced and highly nutritional and cater for varying cultural and dietary needs of the people who use services. EVIDENCE: The home is providing day service to three people using the service with more profound learning disabilities. This service is provided in a separate building located in the back garden of Pettsgrove. This day service can be and is used by some people from the two other services run by SFI, the registered provider informed me that the day service can also be accessed by external providers. The other people using the service access day services provided by Brent Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 12 Social Services. I viewed activity plan in care plans assessed, which showed a variety of activities offered to people using the service. People using the service are encouraged to participate in domestic activities such as setting the table, launder their clothes, etc. I viewed individual programmes to teach people using the service new skills. People using the service went the day before this key inspection to Whipesnade Zoo and different outings are planned throughout the summer. The home has a minibus available, which can be used by all people using the service, and a designated driver is employed by the organisation. The staffing ratio is on average 2.5 staff per 6 people using the service, this appears to be sufficient, I asked the registered provider to review this for weekends to enable people using the service a wider range of community based activities if they choose to do so. Families are involved in peoples live and are invited to review meetings. The home informed me that people using the service can see family members in private and sexuality is addressed within care planning processes. People using the service were dressed appropriate to their gender. I viewed feedback received from one family member, which was very positive. People using the service can access all areas in the home and bathrooms can be locked from the inside to maintain privacy. People using the service preferred form of address is recorded in the care plan folder. I observed people using the service relaxing on their own and interacting with other peers. The atmosphere in the home appeared relaxed and interactions between staff and people using the service was unrushed and friendly. The home is providing two cooked meals every day. I observed the registered provider cooking chicken, rice, potatoes and vegetable for lunch. The registered provider informed me that she is currently in the process of introducing a new menu, which will be discussed with people using the service in the next residents meeting. The menu viewed by myself was varied, healthy providing a range of English and cultural dishes .The fridge was well stocked, and fruit and vegetables are available. People using the service take their meals together and staff support people who need support with feeding. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each resident’s plan; they give a comprehensive overview of their health needs and act as an indicator of change in health requirements. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. EVIDENCE: The home is providing personal care guidelines for people using the service and I viewed records of these in care plans. Toilets and bathroom can be locked to maintain peoples privacy. People have been dressed appropriately for the time of the year and gender. Staff employed by the home comes from various ethnic backgrounds, which reflects people using the service cultural and religious origin. People using the service are fully mobile and the home is currently not using any technical aids to lift people. The home is able to access clinical support through Brent Learning Disabilities Partnership and records of Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 14 visits and outpatient appointments were clearly documented in peoples care plans. All people using the service have a designated key worker allocated. I viewed clear records of visits to health care professionals such as General Practitioner, Psychiatrist, Psychologist, Dentist, Chiropodist, etc. The home is following up when people’s health care needs are changing. People are registered with a General Practitioner of their choice. The homes medication policy is of good standard and compliant with National Minimum Standards and has been reviewed on 10/04/07. The home is recording medication received and disposed of and all staff have recently attended medication training. Medication is stored safely in a lockable cabinet. Medication Administration Sheets have no gaps. I noted that the home is administering eye drops to one person, which expires four weeks after opening. It is however not clear when the bottle was opened, to minimise the risk of administering medication which is expired the home must record the date when opening liquid medication and eye drops. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. The complaints procedure is supplied to everyone living at the home and is displayed in a number of areas within the service. The policies and procedures for Safeguarding Adults are available and give clear specific guidance to those using them. EVIDENCE: The home received one complaint since the last inspection, which has been investigated by Brent Social Services following local Protection of Vulnerable Adults procedures. The home did not receive an outcome of this investigation and is still awaiting feedback from the investigating agency. The home has a complaints policy in place, which is available in people’s rooms. The procedure is available in user-friendly format. Staff has received the necessary checks to ensure that they are safe to work with vulnerable adults and training is provided to ensure appropriate responses to allegations of abuse. Staff spoken to demonstrated good knowledge and understanding of Protection of Vulnerable Adults procedures and a range of policies such as whistle blowing, receiving gifts, bullying, dealing with violence and aggression, etc. are in place. Policies have been reviewed in April 2007. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is a very pleasant, safe place to live the bedrooms and communal rooms meet the National Minimum Standards. The home is well lit, clean and tidy and smells fresh. The management has a good infection control policy in place, which is reviewed regularly. EVIDENCE: Pettsgrove is a spacious building and accommodation is provided on both floors. All rooms are single occupancy and toilet facilities are available on both floors. People using the service have access to a large living room, which is nicely decorated and a well-maintained garden can be used during the summer. The home has a pet rabbit, which is fed and taken care of by people using the service. A small vegetable patch to grow tomatoes, potatoes, etc is used by people using the service. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 17 The utility room is on the ground floor and can be accessed without taking soiled clothing through the kitchen. The home was clean and free of any offensive odours. I noted that the utility room is in need for painting and cupboard doors under sink became loose, which must be repaired. Policies regarding Food Safety, Infection control are in place and have bee reviewed in April 2007. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. Staff members undertake external qualifications beyond the basic requirements. The service has a good recruitment procedure that clearly defines the process to be followed. Staff meetings take place regularly. EVIDENCE: The registered provider informed me that all but one staff have or are currently in the process of obtaining the National Vocational Qualification in Care. This is meeting the required 50 of the National Minimum Standards. Staff spoken to demonstrate good understanding of peoples needs and conditions. The four staffing files assessed showed that staff comes from different backgrounds with a range of skills and experiences in care. The home has provided evidence that they filled out the National Minimum Dataset social care. The home does not employ staff under the age of 18. I viewed four staffing files during this inspection. It was evident that files have been re-organised recently, but I judged the files as poorly maintained, which has been raised with the registered manager. The home is obtaining the Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 19 required checks on new staff and documentation was available in the files I have assessed. Staff has attended a range of different training, this is mostly depending on the lengths of service. One fairly new member of staff informed me that he has received induction training and I overheard the registered manager informing him of Food Hygiene training, which has been arranged. The home is supporting staff development and one senior member of staff informed me that she is currently in the process of doing her National Vocational Qualification in Care Level 4. Staff has an annual training plan in place and money is put aside to provide training to staff and meet future training needs. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in the area. This judgement has been made using available evidence including a visit to this service. The registered person has the skills and ability to deliver good business planning, and effective financial controls, they provide a quality assurance and monitoring process to ensure efficient running of the home. The manager has the necessary experience to run the Home. Checks show that records are up to date and appropriate certificates are in place. EVIDENCE: The registered manager Mr Otis Pinnock has a certificate in Management. The registered provider informed me that he does not hold a National Vocational Qualification in Care Level 4. I was also told that the home is planning to change the management structure of the home once the deputy manager has completed her National Vocational Qualification in Care Level 4. Staff spoke Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 21 very positive about the support they receive from the registered manager and registered provider. A valid insurance certificate is displayed. I noted that the home is still displaying the old NCSC registration certificate and I have forwarded information to the Regional Registration Team to issue the home with a new certificate. The registered provider informed me that the home has conducted user surveys last year and I have viewed positive feedback in these surveys. I was shown a draft form of the new surveys for staff and people using the service, which are to be send out soon. I was told that the home is planning to analyse the feedback and will forward an annual development plan to the Commission for Social Care Inspection. People using the service are encouraged to participate in regular meetings and minutes of these have been made available for inspection. The home informed me through the Annual Quality Assurance Assessment that certificates are in order, which was confirmed during this visit. Fire records are of good standard and drills are undertaken monthly. Previously it was required to inform the Commission for Social Care Inspection of significant events, which has been complied with. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 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 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 23 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. Standard YA20 Regulation 13(2) Requirement To minimise the risk of administering medication which has expired the home must record the date when opening liquid medication and eye drops. Timescale for action 01/09/07 2. YA30 23(2)(b)(c) The walls in the utility room must be repainted and the cupboard under sink must be repaired. 17(2)(3) The registered manager must ensure that records, files and documents are maintained. The registered manager must ensure to forward a copy of the annual development plan to the Commission for Social Care Inspection once completed. 01/10/07 3. YA34 15/09/07 4. YA39 24(2) 01/10/07 Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 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. 1. 2. Refer to Standard YA6 YA13 Good Practice Recommendations The home should provide a monitoring form for staff to record peoples participation in programmes and tasks. The home should review the number of staffing during the weekends to enable people using the service better opportunities for community-based activities. Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Striving For Independence Group DS0000017477.V337160.R01.S.doc Version 5.2 Page 26 - 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. 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