Inspection on 13/07/06 for The Swallows

This inspection was carried out on 13th July 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 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Swallows 02/11/05

The Swallows 28/04/05

The Swallows 09/11/04

The Swallows 03/06/04

The Swallows 11/02/04

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 The Swallows 183-189 Hanworth Road Hampton Middlesex TW12 3ED Lead Inspector Adrian Gordon Unannounced Inspection 13th July 2006 10:00 The Swallows DS0000017369.V303084.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 The Swallows DS0000017369.V303084.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. The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Swallows Address 183-189 Hanworth Road Hampton Middlesex TW12 3ED 020 8783 0354 020 8783 0354 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) Owl Housing Limited Ms D Brenner Mr David Roger Junior Brum Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9/11/05 Brief Description of the Service: The Swallows is a purpose-built single storey care home. The home is set back from the main road and has a wheelchair accessible well-maintained garden to the rear of the property. The home is registered to accommodate six residents with learning disabilities and is well-equipped for supporting individuals with physical disabilities or mobility problems. Each resident has their own bedroom which is specifically designed to cater for individual needs. The premises is owned by Thames Valley Housing and managed by Owl Housing and provides a service to residents referred by the London Borough of Richmond. Information about the service is available in the Statement of Purpose and Service User Guide. Current fees for the service are £1246 per week. Two residents receive additional funding. The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and completed over the course of one day. The inspection consisted of examination of records, a tour of the premises, observation of care practice, talking to three members of staff and the manager. The inspector had the opportunity to meet five residents. Feedback questionnaires were left for relatives and staff although none were returned. What the service does well: What has improved since the last inspection? The information held on resident files is of a much better standard. Up to date Care Plans and risk assessments are in place for all residents and these give a clear picture of their needs and how these will be met. All staff now have training profiles which show training carried out over the last year and any training needs for the current year. Recruitment records for staff are now satisfactory and contain all the necessary information. There is also good recruitment information provided on agency staff. The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 6 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 Swallows DS0000017369.V303084.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 The Swallows DS0000017369.V303084.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents have good information about the home which enable them to make an informed choice. EVIDENCE: There have been no new residents admitted since the previous inspection. Most residents have been at the home a number of years and the manager was able to show original assessments completed on admission. The home is appropriate for all the current residents. There is good information about the home in the Service User Handbook which was updated in January 2006. It is in large print and contains symbols and pictures to help residents understand. Signed tenancy agreements are in place for all residents. The Swallows DS0000017369.V303084.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Good care planning ensures residents needs are met and they are supported to achieve goals. EVIDENCE: Resident files were of a good standard and up to date Care Plans are in place. These are in pictorial and written format and give a clear picture of how their needs will be met. All residents also have Essential Lifestyle Plans which are easy to read and made user friendly with the addition of personal pictures. These include information about likes/dislikes, ‘important things’, health, friends and the home. Residents were seen throughout the day to be given the opportunity to make choices and decisions. One resident was asked at lunchtime if they wanted to pour their own drink or whether they needed assistance. One residents care plan said that they preferred to be called mate by staff. This was seen to be carried out in practice and shows respect for residents wishes. One resident The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 10 was assisted to make tea for everyone and was given the choice of what things he wanted to do e.g. pour the milk. Residents are able to choose how they want their bedrooms to be decorated and one resident had written guidelines on how they prefer to keep things under control in their room which shows empowerment. Resident meetings take place every week and minutes contain a picture of each resident together with any comments they made at the meeting. For example, when discussing activities two residents said that they would like to go to the seaside. Holidays are also discussed at these meetings. In the agency staff induction file, it is made clear that staff should offer residents choices rather than telling them what to do. Risk assessments are in place for all residents and these are regularly reviewed. These cover all aspects of residents daily life including personal care, mobility, road safety and transport. The Swallows DS0000017369.V303084.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents have the opportunity to take part in appropriate activities of their choosing which allow for personal development. EVIDENCE: As well as attendance at day centre there are regular individual ‘community outings’ when residents can go out locally with a member of staff and link person at the day centre. Residents are able to access a range of other activities including weekly classes in dance or music. The daily shift plan details the planned activities for each resident and includes tasks which some of them like to do at the home, for example watering the plants, sweeping the patio and bringing the bins in. The Service User Handbook makes it clear to residents that they have rights, including the right to have their sexuality and intimate relationships respected. Access to specialist support is available externally should the need arrive. Relatives and other visitors are made welcome at the home. One resident is The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 12 supported in their cultural identity by being able to play Bollywood movies in their bedroom, and having access to the Koran on CDs Residents help choose meals for the week ahead every Saturday. The menus are then written up and are made available in picture form. Records of meals are kept and these show that there is a good variety of nutritious and healthy food. Fruit was available from a bowl in the kitchen. The Swallows DS0000017369.V303084.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 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 good. This judgement has been made using available evidence including a visit to the home. Good support is in place to meet residents health needs. EVIDENCE: A number of residents had significant health needs, in particular, problems due to epilepsy. There was a large amount of information around the home to support staff in dealing with these needs, including guidelines for dealing with seizures, peg feeding and physiotherapy. Staff also receive specialist training to ensure they have the required skills. Staff were observed to treat residents sensitively to protect their dignity. For example one resident who had a seizure was able to continue sitting in the lounge while staff monitored discreetly from a distance. Resident files contained good information about health issues and there was evidence of support from external services such as speech and language, an epilepsy nurse, district nurse and occupational therapist. Two residents have Health Action Plans which are being written with the support of a Community Health Nurse. The manager said that these are to be completed for all residents. The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 14 Medication procedures are satisfactory and Medication Administration Record Sheets (MARS) were recorded appropriately, however there were no medication profiles for each resident. Blister packs are used which are received from a chemist every four weeks. There was no record kept of any medication returned and this must be implemented. Medication records are checked as part of the shift handover process. The Swallows DS0000017369.V303084.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 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 the home. In order to protect residents all staff must be trained in the prevention of adult abuse. EVIDENCE: There have been no complaints since the last inspection. The procedure for making complaints is made clear in the Service User Handbook which also has details of people who residents can talk to if they need to. Staff have still not had training in the protection of vulnerable adults (POVA), despite this being a requirement in the two previous inspections. The manager said that training has been organised but cancelled twice. This must be rearranged at the earliest opportunity. It is noted that temporary staff receive POVA training through their agency on a yearly basis and this is to be commended. POVA guidelines, including local procedures were seen to be available in the office/sleep-in room. Staff spoken to were able to demonstrate an understanding of what they would do in the event of a suspected case of abuse. They also showed understanding of Whistleblowing procedures. Resident finances are clearly recorded and receipts kept. The night staff check the recording each evening and random checks are also done by the monthly visitor. All residents have bank accounts and cash cards. The manager is the only person with access to these cards and is responsible for monitoring if a staff or resident has been given one. One residents money contained a note to The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 16 say that £40 had temporarily been taken to subsidise petty cash in March 2006. Using resident money in this way is bad practice and must cease immediately. The money was paid back on the day of inspection. The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 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, 25, 26, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The premises suit the needs and lifestyles of the residents. EVIDENCE: All areas of the home were spacious, clean and tidy. A comfortable lounge was made homely with fresh flowers, plants and pictures. There is some wear and tear, particularly around door frames and skirting boards (due to wheelchair scrapes) and areas of the carpet were stained and worn. The kitchen has worktops that can move up and down to enable residents to prepare drinks and snacks. One wheelchair user was seen to make use of this when making everyone a drink. To the rear of the home is a large, accessible garden. Resident bedrooms were painted in different colours and made individual with personal items such as pictures, soft toys and posters. Bedrooms are furnished with specialist equipment where necessary and two had overhead tracking to assist a resident s in making use of a shared bathroom. One resident was seen to be making use of a special remote control which allows her make use of a TV in their room. The Swallows DS0000017369.V303084.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. A competent staff team ensures that residents are well supported. EVIDENCE: Each shift is led by a Designated Responsible Person (DRP) who coordinates staff duties. OWL Housing provides training for staff in order for them to be a DRP and to get a better understanding of their responsibilities. Two staff have completed NVQ Level 3 in Care. To assist in making handovers effective, a form is used which lists all the various tasks, responsibilities and activities to be carried out that day. Evidence in staff files confirms that Head Office carry out the necessary recruitment checks. Each file also contains an up to date photo of the staff member. There are four staff vacancies and a number of temporary staff are employed, all from the same agency. This agency sends monthly updates which give confirmation of recruitment checks for all their staff. All staff had a training plan for the years 2005 and 2006. These showed details of training already completed and training needs for the future. Training covers a range of core skills such as valuing diversity, health and safety, moving and handling, as well as more specialist training such as chest physiotherapy and The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 19 rectal diazepam. Temporary staff also had training profiles provided by their agency which showed there is a good range of core training to them. Supervisions usually take place every two months and are well recorded. Regular agency staff confirmed that they also receive supervision and are supported by the manager. The Swallows DS0000017369.V303084.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 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 good. This judgement has been made using available evidence including a visit to the home. Residents benefit from a well managed home. EVIDENCE: The registered manager demonstrated a good understanding of the needs of residents and areas of improvement for the home. Since the last inspection the manager has worked to make a number of improvements to the care planning system. He was observed to interact positively with residents and is committed to promoting their rights and choices wherever possible. There is still no formal quality assurance process carried out by OWL Housing which includes feedback from service users, there representatives and all parties involved with the service. There is, however, a quarterly audit of service performance. The manager also showed me some feedback questionnaires which had been given to residents. An up to date business plan The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 21 is in place which sets goals for the home, for example one goal was to ensure new care plans are in place by February 2006. Staff on duty were unsure about the contents of the National Minimum Standards and a copy was not available at the home. A record of health and safety checks is maintained. These were mostly up to date and included a gas safety check, portable appliance test and fire extinguisher test. The manager was unable to find an electrical wiring certificate. Fire points are tested weekly and regular fire drills are carried out. However, the fire evacuation procedures need to be updated and a fire risk assessment must be put in place. Accident and incident records are maintained satisfactorily. The Swallows DS0000017369.V303084.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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 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 2 X X 2 X The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 The registered person must ensure that all residents have a medication profile and that a record is maintained of any medication returned to the pharmacy. The registered person must ensure that resident monies are not misused, in particular, to subsidise petty cash. The registered person must ensure that all staff working at the home receive training in the protection of vulnerable adults. Previous timescale of 31/12/05 not met. 4 YA24 23(2)(b) The registered person must ensure that the walls, skirting board and doors throughout the home are repainted where marked. Previous timescale of 31/03/06 not met. 31/10/06 Timescale for action 31/08/06 2 YA23 13(6) 15/08/06 3 YA23 13(6) 15/09/06 The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 24 5 YA39 24 The registered person must ensure that there is a formal system for monitoring the quality of care provided at the home which includes consultation with residents and their representatives. The registered person must ensure that an electrical wiring test has been carried out, that there is a fire risk assessment in place and that the fire evacuation procedures are reviewed. 30/09/06 6 YA42 13(4)(a), 23(4) 30/09/06 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 YA24 YA39 Good Practice Recommendations The registered person should ensure that the carpet is replaced throughout the home. The registered person should ensure that a copy of the National Minimum Standards is kept at the home, and that staff are aware of the contents. The Swallows DS0000017369.V303084.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 The Swallows DS0000017369.V303084.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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