Inspection on 11/05/06 for Walterton Road (Flat A&B)

This inspection was carried out on 11th May 2006.

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 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Walterton Road (Flat A&B) 06/06/08

Walterton Road (Flat A&B) 27/04/07

Walterton Road (Flat A&B) 18/11/05

Walterton Road (Flat A&B) 20/04/05

Walterton Road (Flat A&B) 03/11/04

Walterton Road (Flat A&B) 13/05/04

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 Walterton Road (Flat A&B) 65 Walterton Road London W9 3PF Lead Inspector Wynne Price-Rees Unannounced Inspection 11th May 2006 10:30 11/05/06 Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Walterton Road (Flat A&B) Address 65 Walterton Road London W9 3PF 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) 020 7289 0533 The Westminster Society for People with Learning Disabilities Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2005 Brief Description of the Service: The home is located in the Maida Vale area with easy access to transport and local amenities including shops. It is registered to provide support for up to ten younger adults with learning disabilities and the accommodation has a lift and is located on the ground and first floors. There is a current full occupancy. The building is in a Victorian terraced suburban street and blends in with its surroundings. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day during which five files were case tracked. The residents were all at home as the day centre most attend was closed for the week. Alternative one to one and group activities were provided to replace those normally provided by the day centre. What the service does well: What has improved since the last inspection? 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. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 6 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 Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 7 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. Assessment information is not being forwarded so that the home can ascertain if needs are being fully met. The quality outcome in this area is poor. EVIDENCE: The home has a full written assessment procedure in place that staff understand and comply with. No new residents have moved to the home since the last inspection. The area of concern has arisen surrounding a resident whom has been identified as benefiting from a move to another of the society’s homes where their needs can be better met. This is in an advanced stage with the resident having visited the prospective new home on a number of occasions, taken some of their possessions over and even having their room decorated There is currently no care manager allocated, by funding the local authority and consequently there has been little input from the social services and no re-assessment of needs carried out by them to determine if the resident would benefit from a move and their needs can be better met. The last internal review on file was dated February 2005 and no social services review was on the current file. Subsequently advocates and the home have carried out assessment reviews. It was identified at the last inspection that a new resident did not have access to their personal allowance money making it difficult for them to make purchases or go out for meals. The organisation has now provided funding in the form of a float although personal finances have not been formally clarified. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 8 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 in place, residents enabled to make decisions about their lives and these are underpinned by risk assessment. Residents meetings do not take place. The quality outcome for this section is adequate. EVIDENCE: Each resident has a care plan in place although the quality of the information varied widely in the sample inspected. Whilst support profiles underpinned the care plans their accuracy regarding currents needs and goals was not conclusive regarding all files seen with some dating back over a period of years. This was compounded in some instances where IP log reviews were either not carried out or not on file. The daily logs did not match goals set in a number of instances and tended to be prescriptive of a residents’ day making it difficult to track progress made. The home’s management and staff team are aware of the shortfalls in the recording process and have introduced a review system to highlight poor practice and ensure staff are aware of their responsibilities and the recording style and content required in this and other areas. Flaws in the system have been identified such as one resident whom had a goal set of swimming weekly. The daily logs were checked between 26/02/06 and 14/03/06 and no entries were found regarding this goal. It was explained that the resident had originally wished to do this activity, but Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 9 subsequently decided against it. If it had been recorded that the activity had been offered and refused within the daily logs, the goal could be replaced with another more appropriate one that the resident would wish to pursue. Observation of care practices showed residents were encouraged and supported to make decisions regarding activities they wished to pursue including daily household aspects such as watching TV, making a cup of tea, sitting in the garden, choosing lunch and where and when to have it. Some residents also decided to go shopping. One resident was asked if they had breakfast yet and when they indicated they hadn’t, they were supported to make their breakfast. The residents chose activities and pursuits they would like to follow whilst the day centre was closed. No residents meetings have been taking place and the management team feel this could be a useful forum to get more residents views and be an opportunity for the residents to get to know each other better. All risk assessments were up to date including those pertinent to each resident and the general house ones. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 10 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. Residents participate in appropriate activities including those within the community; have contact with friends and family and their rights are respected. They receive a choice of meals and health diet is promoted and monitored. The quality outcome for this section is good. EVIDENCE: The residents participate in a number of activities of their choice when attending the day centre during the week. The home is introducing a new system whereby each resident will have one week day at home that will be designated an activity day with the responsibility for organising and agreeing the activity, chosen with the resident, being that of the link worker. They will be required to draw up an action plan and activity list that will be incorporated in the new service review. This will include participation in the life of the area such as using local shops and amenities. The action plan is intended to feed activity planning in the longer term to provide a variety of options further a field and promote more joint working with the day centre service. Currently a number of activities are taking place such as pub visits, walks in the park, meals out and visits to friends in other homes. Each week residents also take it in turns to purchase goods such as bread and milk. One resident has Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 11 purchased a bike and enjoys going out on it. There is also an organisational newsletter that residents contribute to which rotates between the homes and describes available activities and other information such as travel guides and film reviews. There is a heavier emphasis on activities at the weekend as the residents are at home. Family and friend links are well maintained with frequent visits. Observation and documentation showed meals and mealtimes are flexible and tailored to the lifestyle needs and choice of the individual. Healthy eating is promoted and encouraged with diets monitored. One resident has their weight monitored regularly and this is made into part of a social activity as the weighing takes place in a home they used to live in and therefore gives them the opportunity to see old staff and friends. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 12 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. The residents receive personal support in the way they prefer with physical and emotional health needs met although medication administration recording requires improvement. The quality outcome for this section is adequate. EVIDENCE: Personal support is part of the care planning process and provided in private. Where possible gender preference is adhered to. The residents are all registered with GPs and have access to community based health care services including dentists and chiropodists who either visit the home or residents visit them. There is a rolling training programme and all staff have full induction training that includes medication administration. Currently new health action plans are being developed as part of the service review and one resident attended a health check during the inspection. The medication administration records were checked and there was found to be gaps in the recording with no explanation. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 13 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. Residents’ views are listened to, acted upon and they are protected from abuse and self-harm. The quality outcome of this area is adequate. EVIDENCE: The complaints book was checked and fully documented with outcomes. There were twenty-seven complaints since the previous inspection. There is some confusion whether the complaints book should be signed by the home’s service manager or senior duty officer as the procedure is unclear regarding this. The complaints policy and procedure is included in semi-pictorial form in the residents’ guide. Complaints are responded to within twenty-eight days and training has been given to support residents to make a complaint. All staff have received adult protection training and are fully aware of the procedure to be followed in the event of abuse being encountered. The organisation is also aware of the POVA and POCA referral procedure. There are no current referrals. A resident’s birthday money went missing and this was fully investigated including police notification. The investigation was inconclusive and the organisation re-imbersed the money with an apology. To make up for this all staff have agreed to take the resident out for an activity of their choice individually. All financial transactions are recorded and checked daily. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 & 30. The residents live in a safe, clean, hygienic and homely environment with suitable toilet and bathroom facilities except one resident. The quality outcome for this section is adequate. EVIDENCE: A tour of the building showed that residents are provided with a safe, homely, warm and comfortable environment to live in. Concerns were expressed by the family of the new resident and staff about the appropriateness and safety of the shower chair used for transfer that accompanied them from the previous home. An OT assessment showed the shower chair was not appropriate and a new one has been on order for two months. This has meant the resident has had limited showering access. The lounge door of flat A does not open. The home was found to be clean, hygienic and odour free. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 15 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 & 35. Staff do not appear fully conversant with their roles and responsibilities surrounding documentation and recording. The staff are suitably qualified and competent regarding daily care and have received appropriate training. There is a thorough recruitment procedure in place that is followed and documented. The quality outcome for this section is adequate. EVIDENCE: There is a new management team in place that have identified a number of service delivery areas with staff that are not adequately meeting the requirements of the organisation and minimum standards. Consequently an induction plan has been introduced whereby service delivery has been broken down into eight modules that are being revisited by the team so that the shortfalls can be addressed. This will work in tandem with the rolling training programme available to staff and they will be enrolled on courses in areas required. Insulin dispensing training is scheduled for the week after the inspection. Whilst all staff have received medication administration training there were gaps in the recording and this highlights the need for the induction plan. From this each staff member will have a strategic action plan to improve areas of their work that they and the management team feel need to be addressed. Observation of care practices showed that staff have a high level of commitment to meeting the needs of individual residents on a daily basis, but this needs to be focused more on covering all aspects of their roles. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 16 Two support workers enrolled on NVQ level 2 training in January and two more are due to commence in June. One has approached the society to NVQ level 3 and another is doing level 2 externally. The staff rota showed there are adequate numbers of staff on duty at all times. There have been three staff vacancies since the beginning of the year and two recruitment drives have only been successful in filling one of the posts. The project has a comprehensive recruitment procedure that is based on equal opportunities. Copies of staff contracts that include employment terms and condition are held by the organisation’s HR department. Staff performance is reviewed three and six monthly in their first year of employment and annually there after. There are also annual appraisals. All staff have been CRB cleared or are awaiting a CRB response and those without clearance do not work unsupervised unless they have received the POVA check. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 17 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. The home is well run and the health, safety and welfare of residents is promoted and protected. Although their views are the cornerstone of the quality assurance system this has not picked up shortfalls in service delivery adequately. The quality outcome for this section is adequate. EVIDENCE: The new management team has been in place for two months, identified shortfalls in service delivery and introduced systems to combat this working in tandem with the staff team. The Service Manager and deputies have prior management experience in other projects and are due to complete NVQ 4 in June 2006. Although the organisation operates a quality assurance system, this has not picked up service delivery shortfalls identified at this and previous inspections adequately and therefore these have not been addressed at an organisational level. This was reflected in the monthly provider visitor reports forwarded to the CSCI that did not identify a lot of the shortfalls. The reason for this could Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 18 be the system operated whereby particular aspects of the service are chosen, to be checked, at a given visit and also the recording format that only provides one entry line for specific service areas. Having said this, now that the areas to be addressed have been identified, input has been received from a senior peripatetic manager and action plans agreed. Induction training has included required training such as moving and handling, fire safety, first aid and food hygiene. The requirements of standard 42:3 were met and fire evacuations carried out and recorded. He last evacuation took place on 11/03/06 and the fire fighting equipment is serviced annually. Accident and incident books are maintained and appropriate notifications forwarded. Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 19 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 2 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 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 3 X Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 20 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 YA2 Regulation 12, 14 (1) & (2) Requirement Assessed information received must be up to date and complete to make sure the placement is appropriate to meet needs. This is a repeat requirement from the previous inspection. Timescale for action 11/05/06 2. 3. 4. YA2 YA8 YA6 12, 14 (1) & (2) 12 15 Placing authority reviews must 11/05/06 take place on time and documentation provided. Minuted residents meetings must 11/06/06 be introduced. The daily log sheets must reflect 11/06/06 progress made towards care plan goals set rather than prescriptive of a resident’s day. This is a repeat requirement from the last inspection. The new resident’s finances must 11/06/06 be clarified and appropriate access to them provided. Responsibility for signing of 01/07/06 complaints must be clarified within the complaints procedure. The medication administration records must be fully completed following the symbol chart. DS0000042266.V292233.R01.S.doc 5. 6. YA2 YA22 14 22 7. YA20 13 11/05/06 Walterton Road (Flat A&B) Version 5.1 Page 21 This is a repeat requirement from the previous inspection. 8. 9. 10 11. YA27 YA39 YA39 YA39 12 & 23 (2) 23 (2) 24 24 The new resident’s shower chair must be delivered. The flat A lounge door must be fixed. The monthly visit pro-forma must be reviewed. The monthly visits must endeavour to identify shortfalls in the standards as part of the quality assurance system. This is a repeat requirement from the last inspection. Staff vacancies must be recruited to and reasons why difficulty is experienced filling these posts investigated. The organisation’s quality assurance system must be reviewed so that it carries out its purpose. 21/05/06 25/05/06 01/08/06 11/06/06 12 YA33 18 01/09/06 13 YA39 24 01/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Walterton Road (Flat A&B) DS0000042266.V292233.R01.S.doc Version 5.1 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!