Inspection on 14/07/05 for Torkington House

This inspection was carried out on 14th July 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 but made no statutory requirements on the home.

Other inspections for this house

Torkington House 09/09/08

Torkington House 15/01/07

Torkington House 12/01/06

Torkington House 07/01/05

Torkington House 04/06/04

Torkington House 26/11/03

Torkington House 20/06/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Torkington House Cheswick Road Acton London W3 9HF Lead Inspector Gavin Thomas Unannounced 14 July 2005 at 10.40am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Torkington House Address Cheswick Road, Acton, London W3 9HF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 992 5187 0208 896 1196 Greensleeves Homes Trust Mr Chris Ghoorunsing Surnam Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7/1/05 Brief Description of the Service: Torkington House was established in 1947 as a residedntial club for older people. It was later registered as a residential care home. The home is situated on a quiet street in Acton. There are no shops or services in the immediate vicinity. The property is a large attractive detached Edwardian house, dating from 1899. An extension to the home is now complete and opened. The new accommodation is attractive with state of the art facilities and en- suite bedrooms. The home is now registered to provide for thirty two service users. Torkington House is owned and managed by Greensleeves Home Trust. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over six hours. During this time, the Inspector spoke with individual service users, examined records and management systems, met with the Registered Manager and the Training Manager and carried out a partial tour of the home. Four they • • • • • • • • service users spoken to were very positive about the care and support receive. Some of the comments made by service users were as follows: The food is very good. The activities co coordinator does a good job, but it would be nice if more service users took part in activities. Day and night staff are helpful. Drinks are available throughout the day. The service is dedicated to meeting the needs of the elderly. The bedrooms are comfortable. Pleased with the new wing (extension). Torkington House is a good place. The atmosphere in the home was welcoming and pleasant. Twelve service users and eight relatives completed surveys for the purpose of this inspection. All service users indicated that they like living in the home. Service users stated they feel well cared for, they are treated well and they feel safe. Three service users stated that sometimes they would like to be more involved in decision-making. One service user said that sometimes their privacy is respected. One service user said that sometimes they like the food and two service users stated that sometimes the home provides suitable activities. All eight service users stated that they would know who talk to if they were unhappy about their care. All eight relatives stated that they are made to feel welcome in the home. The relatives stated that they are kept informed of important matters. In their opinion there are always sufficient staff on duty and they were aware of the home’s complaints procedure. Additional comments made by individual relatives were as follows: • We are pleased and grateful for the care provided. • The home is like an extended family. • Staff are friendly and helpful. The Inspector takes this opportunity in thanking service users and relatives for giving their views and opinions about the quality of this service. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? The home had implemented five out of the six requirements made at the previous inspection. The one requirement outstanding has been brought forward to be actioned. The home has employed an activities co coordinator. The appointment of this person now enables the home to offer service users a more structured programme of activities. The new wing is now complete and opened. This has improved the overall provisions of service. The new accommodation now provides eighteen service users with en suite bedrooms, adapted bathing and showering facilities and a spacious lounge which looks out on to the garden. Since the opening of the new wing, all service users can now enjoy their meals in a spacious and wellequipped dining room. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 7 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. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 3 The home’s Statement of Purpose and Service User Guide contains a wealth of information. Good systems were in place for assessing prospective service users. EVIDENCE: A Statement of Purpose and Service User Guide were in place. The contents of both documents were in keeping with Schedule 1 of the Care Homes Regulations 2001 and Regulation 5 respectively. Both documents were professionally presented. Processes were in place for assessing prospective service users prior to admission. The Registered Manager said there have been no changes to this process. Senior staff are now being trained to carry out initial assessments with prospective service users. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 10 The home must confirm in writing to prospective service users that having regard to the assessment, the home is suitable for the purpose of meeting their needs in respect of their health and welfare. This home does not provide intermediate care. Therefore, this standard was not assessed on this occasion. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 11 The home has good care planning systems in place, which provides staff with the information they need to satisfactorily meet service users needs. The medication at this home is well managed. EVIDENCE: Care plans were in place for all service users. Care plans examined were well written. Care plans were reviewed on a monthly basis. The Registered Manager said that care plan reviews are carried out by service users and their key workers. Associated care planning records such as service users daily routines and daily reports were also in place. Although service users risk assessments were reviewed regularly, the outcomes were not always recorded as robustly as care plan reviews. The outcome of risk assessment reviews should be recorded in more detail. Service users health needs were set out in their care plans. Health monitoring records were also in place. The Registered Manager said that none of the service users had pressure areas at the time of this inspection. All service users had access to primary health care treatments. Referrals are made via the GP for specialist health care treatments when required. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 12 A medication policy was in place. There were no changes to this policy. The storage of medication and procedures for the administration of medication were satisfactory. Pharmaceutical audits are carried out every three months. Only senior staff are authorised to administer medication. Senior staff had attended refresher training on medication. A policy on dying and death was in place. Service users are under no obligation to disclose details of their last wishes to the home. If known, these details are recorded on service users care plans. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 The home provides a programme of activities, which is tailored in accordance with service users wishes and preferences. Dietary needs of service users are well catered for with a balanced and varied selection of foods available that meets service users tastes and choices. EVIDENCE: An activities coordinator was appointed in May 2005. The activities coordinator works for twenty hours per week. A programme of activities is devised weekly in consultation with service users. The provisions for activities are more structured since the appointment of the activities coordinator. The Registered Manager said that service users have given positive feedback on activities since the activities coordinator came into post. Trips into the community are now happening more frequently. This includes trips to the local parks, shops and short walks. Serviced users told the Inspector that they enjoyed the different types of activities they could choose from. One service user was of the opinion that other service users should show more interest in the activities. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 14 Service users religious persuasions were set out in their care plans. The Registered Manager said that service users religious beliefs and practices are identified prior to admission. The home continues to support service users in maintaining positive links with relatives, friends and significant others. The Registered Manager said there were no concerns regarding visitors and visiting arrangements. As previously reported, the home would prefer that social visits did not disrupt meal times. Details on advocacy services are now displayed in the main entrance of the home. The home continues to provide freshly prepared wholesome and nutritious meals. A full time chef is employed. The chef communicates daily with service users with regards to their choices and meal preferences. Service users spoken to made very positive remarks about the quality and quantity of food. Good records are kept of all meals served to service users. The new dining room is attractive and fitted with good quality furniture and fittings. The Registered Manager said that research was carried out to provide suitable dining furniture for frail elderly people. The dining room has the capacity to seat all service users at any one time. The Inspector spoke briefly with one service user about the dining provisions, when lunch was being served. The service user said that the food is good and they like the dining room very much. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a satisfactory complaints system in place. Service users are encouraged to express their views and opinions. Good training provisions were in place to keep staff abreast of current practices to maximise service users safety and protection. EVIDENCE: A complaints policy and procedure was in place. The last complaint received by the home was in 2001. In light of this, a complaints record was not in place. The home was advised to implement this record to ensure that any complaint received is properly documented. The complaints procedure was displayed in the main entrance. A suggestion, comments, complaints leaflet was also displayed in the main entrance. Adult Protection policies and procedures were in place. The adult protection reporting procedures now includes the details of Regulatory Bodies to whom adult protection matters should be reported. The home was in receipt of the London Borough of Ealing adult protection procedures. The home was also in receipt of the Department of Health No Secrets guidance document and a whistle blowing policy. Adult Protection training has been scheduled for August 2005. The Registered Manager said that there were no concerns with regards to the safety or protection of service users. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 16 The Registered Manager confirmed that no staff had been referred for inclusion on the POVA register. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20. 22 & 26 Recent investment has significantly improved the appearance and facilities for frail elderly people. Further improvements are also being made to improve overall provisions. Furnishings and fittings provided are of good quality. EVIDENCE: The home was very clean and well presented throughout. The new wing is now fully opened. The provisions in this extended part of the home are suited to the needs of elderly people. The rear garden is pleasant with seating, lawns and a decking area. Walk – in showers are situated on the first and second floors. Other facilities in the extension include a lounge, dining room and office on the ground floor. A lift is also provided in the new wing. The Registered Manager said that application has been made to the local council for approval to extend the kitchen, staff facilities and laundry room. Once this work has been achieved, the rest of the home will be renovated and refurbished. All bedrooms will then have en suite facilities. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 18 Communal rooms currently provided are two lounges and one dining room. The accommodation in the new wing is in keeping with the criteria as set out in standard 21.6 of the National Minimum Standards for Care Homes for Older People. Handrails are positioned in corridors throughout the home. The home has one parker bath. Hydraulic seats are provided in baths and showers. Ramps are situated at all entrances to the home, which are used by service users. Policies and procedures on the control of infection were in place. The Inspector observed staff wearing protective clothing at the time of this inspection. Hand washing facilities were prominently sited throughout the home. Proper facilities were used for the storage of clinical waste. The Registered Manager confirmed that an approved contractor was responsible for the disposal of clinical waste. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 & 30 Staff morale is good, resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. Good provisions were in place for staff training and development. EVIDENCE: Staffing levels are maintained as follows: Early shift – One senior support worker and three support workers. Late shift – One senior support worker and two support workers. Night shifts – Two waking night staff. Staff rotas examined were satisfactory. The Registered Manager said that the numbers of staff on duty at any one time would increase when the home is full to capacity. The Registered Manager is supported by one Deputy Manager, one Assistant Manager and one part time business support staff. In addition to care staff, the home has an activities coordinator, a full time chef, a part time kitchen assistant and three domestic staff. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 20 The home currently employs seventeen care staff. Seven staff have an NVQ Level 2 in care and one staff has an NVQ Level 3 in care. Two staff were working towards the NVQ Level 3 in care. Based on the current numbers of staff employed, 50 of the staff have a relevant NVQ in care. This meets the criteria as set out in standard 28.1 of the National Minimum Standards for Care Homes for Older People. A staff training and development programme was in place. Individual staff training and development profiles were also in place. TOPSS induction and foundation training programmes were in place. In addition to this, all new staff are required to attend in – house induction training. Staff were attending health and safety training on the day of this inspection. The Training Manager for Greensleeves Trust provided this training. The Training Manager facilitates a range of in house training courses. The home also purchases training from external providers. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 The Registered Manager has a clear development plan and vision for the home. The home has instigated good systems for reviewing aspects of its performance. EVIDENCE: Quality assurance and monitoring systems were in place. Business objectives for the period April 2005 to April 2006 had been identified. A management report was incorporated in the business plan. Surveys had been issued to service users, relatives and significant others. The Registered Manager was still in the process of collecting completed surveys. Once this is done, the results of the surveys with findings and if necessary, an action plan will be published. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 22 Staff meetings are held four times a year. The Inspector can confirm that copies of reports for visits carried out as required under Regulation 26 of the Care Homes Regulations 2001 are submitted to the CSCI. Health and safety policies and procedures were in place. The Registered Manager said there were no changes to health and safety procedures. Records examined indicated that gas, electrical and fire appliances are tested routinely by approved contractors. A legionella test was carried out in September 2004. The results of the water samples taken were satisfactory. Hot water delivered to bathing and showering facilities is tested regularly. Records examined confirmed this. Staff attended updated fire safety training in May 2005. The record of fire drills now includes the times of drills and the length of time taken for evacuation. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x x 3 x x x x 3 Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 24 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 3 Regulation 14(d) Requirement Timescale for action 31/8/05 2. 16 17(2) Schedule 4 - 11 The home must confirm in writing to prospective service users that having regard to the assessment, the home is suitable for the purpose of meeting their needs in respect of their health and welfare. (Timescale of 28/2/05 Not Met). A record for complaints must be 31/8/05 devised and implemented. 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. Refer to Standard 7 Good Practice Recommendations The outcome of risk assessment reviews should be recorded in more detail. Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Ground Floor 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 Torkington House G61-G10 s27744 Torkington House v214223 140705 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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