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

This inspection was carried out on 27th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 2 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) 11/05/06

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

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Ashlong House

Norbury Crescent (30)

Edenvale

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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 27th April 2007 10:30 Walterton Road (Flat A&B) DS0000042266.V337449.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 Walterton Road (Flat A&B) DS0000042266.V337449.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. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 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.V337449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2006 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 currently one vacancy. The building is in a Victorian terraced suburban street and blends in with its surroundings. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over two days with nine hours spent on site. The home is currently considering re-registering as two separate home’s, one on each floor that was its original registration. Consequently it is operating with separate staff teams on each floor with delegated Deputy Team Leaders. During the course of the inspection residents and staff were spoken with, records and documentation checked and a premises tour took place. What the service does well: What has improved since the last inspection? What they could do better: The home must make sure that all care plans work uniformly, all required information is up to date, outdated information archived and the same format and documentation used. The progress made must be continued. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Walterton Road (Flat A&B) DS0000042266.V337449.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 Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 4. Quality in this outcome area adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written needs assessment policy and procedure in place that staff understand and follow. No new residents have moved in since the last key inspection although one person is currently considering moving in. They are visiting the home twice per week to help them decide if this is the home for them. They were coming for a meal on the second inspection evening. All the required assessment information had been forwarded to the home so that staff could decide if the prospective resident’s needs and wishes could be met and a placement was appropriate. This included an O.T’s assessment. Referrals to the home tend to come through Westminster Social Services and there are currently no self-funding residents. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four residents’ care plans were case tracked, two from each floor, one male and one female from each. These have been updated from the previous key inspection and are more person centred maximising resident participation. They are more user-friendly adopting terms such as “All about me” and “My support profile” that encourages resident ownership. The information is recorded by combining words and pictorial images to underpin this. The information was up to date, generally well kept and clear although some of the plans were further developed than others. The staff team are aware of the need to make sure all the plans are maintained at a high standard and are working towards this. The plans are now more proactive with monthly forward activity and other necessary information like appointments recorded. Monthly reviews also take place that are fed by daily logs. These still tend to be prescriptive of a resident’s day rather than being focused on identified goals. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 10 There was still little recorded evidence of annual commissioning reviews taking place, on file. The home said there are difficulties with these being cancelled at short notice and information being forwarded when the reviews take place. They felt this varied depending who was the social worker or care package manager with some being very diligent whilst others weren’t. The care plans were underpinned by risk assessments and individual risk taking policies that are regularly reviewed and updated. Observation, conversation with staff and activities records demonstrated that residents’ are empowered and supported to make their own decisions within a risk assessed environment. It was evident that the home’s daily routines revolved around the residents rather than residents fitted in with the home’s routines. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents’ participate in a number of activities identified within their care plans. These are individual and group with some being in conjunction with Lislestone and Droop Street day centres. Quarterly reviews take place with the day centres. On the second inspection day some residents went over to the local park with a staff member and others took advantage of the warm weather by having lunch in the garden. Residents have weekly activity plans that they pursue as they wish. One resident attends a City Lit computer based course whilst another is a staff interviewer for the Westminster Society. Some residents’ attend the Beautiful Octopus nightclub, in Catford, that caterers for residents with learning disabilities. Good use is also made of local amenities such as shops, pubs, restaurants and Paddington Rec. A resident of Moroccan descent goes to Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 12 restaurants in Goldhawk Road that serve food of this type and themed meals also take place at home. The residents’ participate in weekly meal planning, food preparation and participate in purchasing if they wish. Choices are identified using pictures in cookbooks. Each resident has a home-based activities day that incorporates a specific meal of their choice. Trips to the IMAX, musical concerts and other destinations have taken place and a resident went on a boat trip last week. Family links are well maintained with regular visits taking place to or received from families. One resident regularly goes out with a family and a staff member. Families are also invited to barbecues at the home. Dietary requirements are identified as part of the care planning process. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal support is incorporated within the care plans and delivered as and when required in line with the residents’ needs and wishes. Wherever possible gender preference is observed. Personal support is part of core induction training. Each resident has a health care plan and is offered annual check ups. 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 also includes medication administration. A number of requirements were made at a themed pharmaceutical inspection that were met at this inspection. The medication administration, recording, storage and disposal was checked for each resident and found to be appropriate. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a written complaints procedure that is also available in pictorial form and copies were kept on the case files. There is an electronic recording system and brief details are also kept in the written log. These are regularly monitored to check appropriate action has been taken and audited in the quarterly block contract returns. There is an adult protection procedure and staff receive adult protection as part of induction training as well as training in how to deal with challenging behaviour. All staff are CRB cleared prior to commencing in post and there are currently no POVA issues. The Westminster Society is appointee for one resident and everyone else has his or her own bank accounts. Records of all financial transactions is kept and audited during the monthly proprietor’s unannounced visits. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A full premises tour was carried out and the home was found to be generally in a good state of repair. Staff voiced concerns surrounding the masonry at the front of the building. There had previously been an incident when some had fallen. The contractors had been informed and put up scaffolding that is now removed. Although no masonry has fallen recently, the house two doors up is showing signs of cracking and possible falling masonry. The ground brickwork is loose in places, has sunk and could present a tripping hazard. The building is suitable for its stated purpose was clean, tidy, hygienic and odour free. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff observed and spoken to showed a thorough knowledge of their clients and their needs and wishes that they made great efforts to accommodate. There is also a marked improvement in recording within care plans and they have adapted well to the new person centred approach introduced. The composition of the staff team has changed with a number of new staff in post that have brought obvious enthusiasm to their roles. The team have all received induction and on-going training that was reflected in the care practices observed. All have training and development plans, regular supervision and three monthly appraisals. They were competent and professional in discharging their responsibilities whilst maintaining a friendly and caring manner. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 17 The staff rota showed there are adequate numbers of staff on duty at all times. The organisation operates a thorough recruitment procedure that adheres to current equal opportunities legislation and meets the requirements of the standard including CRB checks. Over 50 of staff have attained or are working towards NVQ level 2 or above. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is considering reverting to two registrations one for each floor and currently the staff teams are working separately in preparation for this. Consequently the Care manager post is vacant and two deputy team leaders head the teams up. The Care Manager posts are being recruited to in the next three weeks. The organisation operates a thorough quality assurance system with triggers and performance indicators that are regularly reviewed and acted upon. A number of shortfalls in the system were highlighted at the last key inspection that have now been rectified. The health, safety and welfare requirements of standard 42 were met. Fire fighting appliances were checked and serviced in September 2006, fridge and Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 19 freezer temperatures are checked and recorded daily, the fire alarm system is tested weekly using random call points, water temperatures weekly and evacuations take place monthly. The boilers and central heating are also regularly checked. There were up to date risk assessments in place. The premises are also secure. Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 Page 21 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 YA2 Regulation 12, 14 (1) & (2) Requirement Placing authority reviews must take place on time and documentation provided. This is a repeat requirement from the last key inspection. The must confirm that contractors check there is no danger from falling masonry. Timescale for action 01/06/07 2. YA24 23 (2) (b) 01/06/07 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.V337449.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Walterton Road (Flat A&B) DS0000042266.V337449.R01.S.doc Version 5.2 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. 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