Inspection on 24/11/05 for Tudor Avenue, 3

This inspection was carried out on 24th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tudor Avenue, 3 23/08/06

Tudor Avenue, 3 19/08/04

Tudor Avenue, 3 07/04/04

Tudor Avenue, 3 26/02/04

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 Tudor Avenue, 3 3 Tudor Avenue Hampton Middlesex TW12 2ND Lead Inspector Simon Smith Unannounced Inspection 24th November 2005 12:30 Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tudor Avenue, 3 Address 3 Tudor Avenue Hampton Middlesex TW12 2ND 020 8979 2696 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) London Borough of Richmond upon Thames Ann Elizabeth Bruce Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: 3 Tudor Avenue is home to a maximum of six adults with learning disabilities. The property is owned and maintained by the London & Quadrant Housing Association, whilst management and staffing is provided by the London Borough of Richmond upon Thames. The home is situated in a pleasant residential area with good access to local shops and community facilities. The building occupies a corner plot offering gardens to the sides and rear. A good standard of decoration has been achieved throughout the home. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a single visit and included discussion with the deputy manager, members of the staff team and a resident. Care plans and other records were examined and a tour of the building made. The inspector was made welcome and wishes to thank residents and staff for their help during the visit. The home met 22 of 26 National Minimum Standards assessed at this visit. Three Standards were almost met and one Standard was not met. Eight Requirements were made, one of which was reinstated from the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Support residents’ meetings more frequently. Improve standards of food storage. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 6 Address the areas identified in the ‘Requirements’ section of this report to maintain the appearance of the home. Store all substances potentially harmful to health safely within the home. Conduct health and safety checks more regularly. 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. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 Residents’ needs and strengths are effectively identified. Residents receive good support to achieve their goals and aspirations. EVIDENCE: Care plans indicated that residents’ needs are effectively identified through the assessment process and that this information forms the basis of care and support delivered. The home is committed to ensuring that individual plans are person-centred and reflect the needs and aspirations of residents. Staff liaise effectively with other agencies and residents receive support to access specialist services where necessary. The design and layout of the home meets the needs of those who live there. Adaptations and specialised equipment have been installed where necessary to improve mobility. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 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 Care plans are individualised and reflect the care provided to residents. Residents receive good support to make informed choices about their lives. Residents’ meetings should be held on a more regular basis. EVIDENCE: An individual plan of care is in place for each service user. A standard format is used for this purpose and the standard of recording was found to be good. Care plans record service users’ strengths, needs, likes and dislikes, identify individual communication strategies and list networks of relevant contacts. Inspection of care plans confirmed that residents receive appropriate support to make informed choices about their lives. For example, staff work with residents to achieve individual goals, which are based on needs identified through the care planning process. Individual goals were clear and realistic, identifying a timescale for achievement and identifying the member of staff responsible for support. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 10 The deputy manager advised that there had been some delays in introducing the ‘Total Communication’ package designed to improve opportunities for individual communication but that the speech and language therapist responsible for delivering the programme is now able to offer a regular commitment to the home. The deputy manager also reported that the personcentred planning co-ordinator is to provide up to five sessions with the staff team to develop their skills in this method of working. It is hoped that these developments will improve opportunities for residents to communicate their needs and wishes and provide staff with the skills to respond effectively. The home aims to seek and record residents’ views through meetings, which are supported by staff. The last inspection report required that residents’ meetings be held more often. The most recent minutes on file were from the meeting held in July 2005. This Requirement is therefore reinstated here. See Requirement 1. The Council provides appropriate guidance for staff in the identification and management of risk. Risk assessments are in place addressing specific activities undertaken by residents. These assessments are subject to regular review. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 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, 14, 16, 17 Residents participate in a range of activities appropriate to their needs and preferences. There is a commitment to supporting residents in community participation. Staff liaise effectively with providers of day services. Standards of food storage should improve. EVIDENCE: Resident participate in a range of activities appropriate to their needs and preferences. Two residents attended day services and another attended college. One resident visited a local pool and another went out with a member of staff for breakfast. The deputy manager reported that increasing residents’ involvement in their local community remains a primary objective for the service. Staff are encouraged to think creatively about how they can support residents in their use of community facilities and resources. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 12 The majority of residents currently make use of structured day services and are likely to be affected by proposals for change to the Council’s day service provision. The deputy manager advised that day service staff are developing activities at community based locations and that staff support residents’ attendance of these sessions, although this has posed some logistical problems. In addition, the resource centre has allocated two link workers to the home. The deputy manager reported that the link workers play a valuable role in increasing residents’ opportunities for community participation. All residents have the opportunity to take part in at least one annual holiday and several residents have participated in a number of trips this year. A group of residents and staff was due to travel to Brussels on the day following the inspection. Residents also took part in holidays to CentreParcs in Nottingham and Suffolk and a trip to Lanzarote. Interactions between staff and residents was positive during the inspection. Residents have unrestricted access to all communal areas of the home. Residents’ wishes and needs are clearly identified in their individual plans. Staff used appropriate forms of address when speaking to residents. The advertised menu indicated that the home provides a varied and wellbalanced diet. Responsibility for cooking and preparing food is shared amongst residents and the staff team. All staff undertake basic food hygiene training as part of their induction process. Standards of food hygiene and storage were generally good, although one opened cooked meat product had been stored in the fridge without appropriate resealing or the date of opening recorded. See Requirement 2. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 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): 19, 20 Residents’ healthcare needs are recorded and known by staff. Residents are supported to access community and specialist healthcare resources where necessary. EVIDENCE: All residents are registered with local general practitioners and access other community healthcare resources as necessary. The community nurse provides support to the staff team in managing ongoing healthcare conditions experienced by residents. The deputy manager advised that residents who experience long term healthcare conditions are also monitored by appropriate specialists every three months. There is an appropriate system for the storage and administration of medication. All medication coming into or leaving the home is recorded. There are clear protocols governing the administration of medication. There are no residents who self medicate. Inspection of medication records for three residents revealed no omissions or errors. Training for staff in the administration of medication had taken place since the last inspection following concerns identified by the community pharmacist at her last visit. The deputy Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 14 manager reported that all current staff (including agency staff) have attended training in medication administration. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 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 Appropriate procedures are in place for the management of complaints. The home responds appropriately to any allegations received. EVIDENCE: The home has an appropriate Complaints procedure. The Council provides guidance for staff on handling complaints received and specifies timescales for action and response. No complaints have been made about the home since the last inspection. The home had received allegations since the last inspection concerning the conduct of a member of staff. The home responded appropriately to the allegations, suspending the member of staff from duty. An investigation into the allegations was under way at the time of inspection. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28, 30 The communal rooms of the home are spacious, comfortable and homely. Action is required in some areas to maintain the appearance of the home. Potentially harmful products must stored safely. EVIDENCE: The home is situated in a pleasant residential area and has good access to local community facilities, public transport networks and open spaces. The property occupies a corner plot and has gardens to the sides and rear. These were untidy and would benefit from attention. A gentle slope allows wheelchair access from the house to the garden. The communal rooms of the home include a large kitchen and separate living and dining rooms. All areas of the home were clean and hygienic. The carpets had been cleaned just prior to inspection, which had improved their appearance. A number of measures have been taken to improve security at the home. For example some sections of the perimeter fence have been made higher and security lighting installed in the rear garden. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 17 A number of areas require attention to maintain the appearance of the home. These include the gate to the side of the property (see Requirement 3), the curtain rail in the dining room (see Requirement 4) and the section of external plasterwork adjacent to the front door (see Requirement 5). The home has a laundry room, the door of which was propped open at the time of inspection. The door of the cupboard containing potentially harmful (COSHH) products (sited in the laundry room) was broken, providing easy access to the products inside. An Immediate Requirement was made that the laundry room be locked until the COSHH cupboard is repaired. See Requirement 6. In addition, a cleaning product was found in one resident’s bedroom. An Immediate Requirement was made that all substances potentially harmful to health are stored appropriately within the home. See Requirement 7. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 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): 31, 32, 33, 34, 36 Job roles within the service are clear and defined. Staff receive effective induction, supervision and appraisal. Staff are appointed following an appropriate recruitment and selection procedure. EVIDENCE: The home has a clear management and staffing structure. Job descriptions and contracts of employment are in place for all posts within the staff team. All new starters participate in both a corporate induction and local introduction. Regular staff meetings and use of systems such as handovers and the Communication book, ensure that staff are well briefed on current issues within the home. A staff meeting was due to take place on the day of inspection but was cancelled due to staff sickness. The home had vacancies for one residential support worker and one full-time and one part-time residential assistant at the time of inspection. Additional shifts are also vacant due to additional factors within the staff team. The deputy manager advised that vacancies are covered through the employment of agency staff and the allocation of additional hours to members of the permanent staff team. The deputy manager reported that the home employs Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 19 only agency staff able to offer a regular commitment to the home in order that the continuity of care to residents is maintained. The deputy manager has recently completed the NVQ level 4 award and two staff are working towards the NVQ level 3 award. One member of staff has already completed NVQ level 3 award. Staff spoken to on the day of inspection reported that they receive regular supervision and good support from their managers to perform their jobs. Two staff files were examined. Both provided evidence of an appropriate recruitment procedure, regular supervision and contained pre-employment checks including Criminal Records Bureau disclosure, proof of identity and written references. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42, 43 Residents are consulted about decisions taken within the home. Residents benefit from competent management of the home. Health and safety checks should be made more regularly. EVIDENCE: Systems are in place to capture residents’ views about the running of the home. Residents meetings are held, although these should take place more regularly (see also Standard 7). Residents are consulted about decisions taken within the home. Each resident has a keyworker, who aims to provide advice and support where required. Staff conduct health and safety checks, which include temperature monitoring, food storage, first aid equipment, COSHH storage and fire equipment. The last health and safety check found on file took place on the 6th October 2005. The Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 21 Registered Person must provide evidence that health and safety checks take place more frequently. See Requirement 8. The home manager has access to appropriate line management support and to the central services of the Council where necessary. There is a ‘Service Plan’ in place for the home, which links to the Council’s corporate plan. The service is regularly monitored by the Council’s Quality Assurance officer. The home has valid Employers Liability insurance. Tudor Avenue, 3 DS0000017395.V261238.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 2 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tudor Avenue, 3 Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 3 DS0000017395.V261238.R01.S.doc Version 5.0 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 YA8 Regulation 12(2)(3) Timescale for action The Registered Person must 30/12/05 ensure that meetings designed to enable service users to contribute their views to the running of the home are held on a more regular basis. The Registered Person must 15/12/05 ensure that food products are appropriately resealed and labelled after opening. The Registered Person must 30/01/06 repair or replace the gate to the side of the property. The Registered Person must 30/12/05 repair or replace the curtain rail in the dining room. The Registered Person must 30/01/06 repair the section of external plasterwork adjacent to front door. The Registered Person must 24/11/05 ensure that the laundry room is locked until the COSHH cupboard is repaired. The Registered Person must 24/11/05 ensure that all substances potentially harmful to health are stored appropriately within the home. The Registered Person must 15/12/05 DS0000017395.V261238.R01.S.doc Version 5.0 Page 24 Requirement 2. YA17 13(4) 16(2)(i) 3. 4. 5. YA24 YA24 YA24 23(2)(b) 23(2)(b) 23(2)(b) 6. YA24 12(1)(a) 13(4) 12(1)(a) 13(4) 7. YA24 8. YA42 13(4) Tudor Avenue, 3 23(4)(c) ensure that health and safety checks are conducted more regularly. 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 YA24 Good Practice Recommendations The Registered Person should improve the appearance of the garden. 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