Inspection on 13/10/08 for Whiteheart Avenue, 27

This inspection was carried out on 13th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whiteheart Avenue, 27 06/09/06

Whiteheart Avenue, 27 27/10/05

Whiteheart Avenue, 27 13/05/05

Whiteheart Avenue, 27 09/12/04

Whiteheart Avenue, 27 17/05/04

Whiteheart Avenue, 27 30/01/04

Whiteheart Avenue, 27 15/08/03

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Whiteheart Avenue, 27 Whiteheart Avenue, 27 Hillingdon Middlesex UB8 3EP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Middleton     Date: 1 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Whiteheart Avenue, 27 Whiteheart Avenue, 27 Hillingdon Middlesex UB8 3EP 02085617067 Telephone number: Fax number: Email address: Provider web address: tonyunthiah@yahoo.co.uk Name of registered provider(s): Type of registration: Number of places registered: Mr Koosraj Ramaya Unthiah care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 27 Whiteheart Avenue is a bungalow set in a quiet residential area about one mile from Uxbridge Town Centre. Public transport links to other neighbouring shopping centres are a short walk away. The home is registered for three adults with learning disabilities with an exception for those who pass the age of 65 and who have been residing in the home for a period of time prior to this. The home currently provides a service for two adults with learning disabilities. The residents are one male and one female who have lived in the home since it was opened in 1990. The property has been extended. There are two single bedrooms, lounge and a kitchen/dining room. The extension houses a sleeping in room with en suite facilities and a fourth bedroom with en suite facilities has been built to the rear of the building. The Staff team consists of the Registered Manager, the Deputy Manager, who is the wife of the Registered Manager, and support Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 3 Brief description of the care home staff. One resident attends a day centre five days per week and the other attends three days a week. A programme of activities had been produced for the residents at weekends and evenings. The Registered Manager owns another home for people with learning disabilities in the same road and the residents from the two homes are on friendly terms and share activities, holidays and outings. The fees are from £650, to £750, per resident per week. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection on this service was completed on 6th September 2006. We carried out an unannounced key inspection from nine AM until three PM. During the inspection visit we looked at a residents file, servicing records and spoke with one resident and one member of staff. The Registered Manager will be referred to as the Manager in this inspection report. The Manager had completed an Annual Quality Assurance Assessment, referred to as an AQAA. This is a self-assessment looking at how well outcomes are being met for the residents living in the home. The Manager and Deputy Manager, who own the home, were present and assisted with Care Homes for Adults (18-65 years) Page 6 of 26 the inspection process. The six previous requirements had been met and one new requirement was made from this inspection visit. All of the National Minimum Standards had been assessed at this inspection visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents would be assessed prior to moving into the home. Evidence: There have been no new admissions into the home for several years. We saw the preadmission assessment that would be used. This covered the main areas, such as the prospective residents health and social care needs. The pre-admission assessment considered the prospective residents cultural needs. The Manager acknowledged the need to consider any equality and diversity issues. We advised the Manager, at the initial assessment stage, to also consider recording if a resident had a preference for same gender personal care support. The Manager confirmed that all prospective residents would be encouraged to visit the home and spend time meeting the other residents and staff. The Annual Quality Assurance Assessment confirmed that a pre-admission process is in place and we are confident that any prospective resident would be fully assessed prior to moving into the home. Care Homes for Adults (18-65 years) Page 10 of 26 Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs and risks are assessed, recorded and were being met. Residents are supported to make informed daily choices. Evidence: We viewed one residents file. The Deputy Manager completes the documentation on each resident. She consults with the other members of staff and with the resident. Evidence was seen that the resident had signed some of the documents viewed. The care plan was detailed and recorded the residents likes and dislikes and their preferred routines each day. Their health and social needs were also recorded. The Annual Quality Assurance Assessment stated that the home has made improvements by recording and monitoring the residents changing conditions. The Deputy Manager confirmed that care plans are updated on a regular basis and in particular when there has been a change in the residents needs. Any problems are Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: noted to ensure the members of staff are fully aware of the residents current needs. The home is small and is able to offer the two residents daily choices. The residents are over sixty-five years old and staff recognise that the residents are busy most week days and enjoy resting and relaxing. One resident spoken with stated they were able to do the things they enjoyed every day. One member of staff confirmed that the residents are able to communicate what they do or do not want to do each day. We viewed risk assessments and these recorded the ways to minimise the assessed risks. Where the residents needs have changed this had been noted on their risk assessments. Overall the documentation on the residents file viewed provided clear information about their needs and how the staff team needed to meet those identified needs. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to engage in daily activities both in the home and in the community. Residents are encouraged to maintain social relationships. The meal provision provides the residents with a well-balanced diet. Evidence: The Manager informed us that he and his wife the Deputy Manager had taken the two residents from the home, on holiday. This had also been with the two other residents from the other registered care home, also owned by them on the same road. These annual holidays had taken place every year. This holiday provided the other members of staff time off, which is important as one member of staff lives at the back of the Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: care home. One resident attends a local day centre five days a week, whilst the other resident attends a day centre three days a week. When asked, the resident said they enjoyed going to this centre. The resident spoken with described how they also liked to knit and enjoyed being in the home. One resident has a priest or nun who visits the home, as this resident is no longer able to visit the local church. As stated earlier in the inspection report, the two residents who are over sixty five years old, are active and enjoy carrying on with the routines they are familiar with. Overall staff work with the residents to ensure they are stimulated and occupied. Maintaining contact with their relatives is encouraged. One resident has contact with a relative on an ongoing basis. The Manager keeps the relatives informed of any significant events. Residents are able to lock their bedrooms if they desire some privacy. One residents bedroom is directly off from the living room. Staff were seen to interact with the resident, who was seen during the inspection visit and not exclusively between themselves. The staff team know the residents well, and there was seen, during the inspection visit, positive interactions between staff and the resident. We viewed the menus to see what the residents had been eating. Overall the meal provision was varied and included fresh produce. The residents enjoy traditional English meals and this was reflected in the menus seen. Once a week the two residents help out with the evening meal. This might be minimal participation but staff see it as an important task for each resident to be involved in, so that residents are learning new skills. When asked, the resident spoken with confirmed they enjoyed the food they ate in the home. Staff record what each resident has eaten, including the sandwiches they have taken to the day centres. This enables the staff team to monitor the meals to ensure residents receive a nutritious and well-balanced diet. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported with their personal care in their preferred way. The health needs of residents are recorded and were being met. The robust medication systems in the home protect the welfare of the residents. Evidence: Residents can state their preference regarding who supports them with personal care tasks. One residents file noted that they agreed to receiving personal care support from either a male or female member of staff. One member of staff spoken with confirmed that residents could get up and go to bed when they wanted to. Both residents have a GP and a summary of one of the residents health needs was seen. Residents are weighed every month, so that any changes can be noted and acted on. Staff record when residents have seen a health professional. In order for the outcome of these appointments to be clear and easy to monitor we discussed with the Deputy Manager the benefit of introducing a form that clearly records medical Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: appointments. We viewed the records when the District Nurse had visited a resident who had a leg ulcer. The staff were fully aware of their roles and responsibilities when meeting residents health needs. The Commission is kept informed when residents have been admitted into hospital. One resident had been having difficulties in using the bath and an Occupational Therapist had carried out an assessment and had obtained an electric chair so that the resident could continue having regular baths. We viewed the medication systems in the home. The home stores medication in a locked kitchen drawer. We counted one residents medication and all three medicines were found to be correct at the time of the inspection. Staff attend ongoing training on medication and had been tested on their knowledge of medication before they were issued with a certificate of attendance. The Deputy Manager carries out checks and counts on all the medication in the home each month. Residents allergies are noted and information was seen on the medication in the home and the side effects of these medicines. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place for residents to voice their concerns. These concerns would be listened to and acted on. Systems are in place to protect residents from harm and abuse. Evidence: The home had not received any complaints. There is a complaints policy and procedure in place and had been reviewed in 2008. We discussed with the staff team the benefit in developing a clear complaints record, so that should there be a concern or complaint raised. This would enable the Manager to demonstrate how he had dealt with the complaint and whether it was still unresolved or satisfactorily dealt with. There had been no safeguarding concerns or investigations. The home had a policy on safeguarding dated 2008. They also had the Local Authoritys Safeguarding policy and procedure. Staff attend training on the subject of safeguarding vulnerable adults. We counted both residents personal monies. Each financial transaction is recorded and receipts are obtained. The money checked was correct. Staff explained that residents withdraw their own money, with the support from staff. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall residents live in a welcoming and homely place. The home was clean and free from odours. Evidence: It had been noted at previous inspection visits that some of the rooms had needed attention. We viewed the rooms in the home and was pleased to see that the kitchen had been fitted with new units and the tiles had been painted. The bathroom tiles had also been painted and a new bath panel had been fitted. The outside of the home had also been painted. It is the responsibility of the staff team to keep the home clean and tidy. Overall the home was clean and tidy and free from cobwebs. The Manager should continue to monitor the environment so that the home is well-maintained, clean and welcoming. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team are effective and work in the interests of the residents. There are robust recruitment procedures in place and these safeguard the residents. Staff and subsequently the residents would benefit from an ongoing training programme being in place and available for staff. Evidence: The staff team is small and consists of four people. The team have worked together for several years and are familiar with the needs of the residents. One member of staff said that the team worked well together. The staff team are competent and committed to working in the interests of the residents. One member of staff has NVQ level 2 and the Deputy Manager has NVQ level 4 and 5. Staff meetings are held on a monthly basis and residents usually attend these meetings. We viewed the rota and saw that usually there is one member of staff working with the residents. If there is a need for an additional member of staff, then this is flexible and can be arranged. The rota needs to record and reflect exactly the hours each member of staff works and this was discussed with the Manager. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The Manager had not recruited any new staff to work in the home. We viewed the staff employment file viewed at the last visit as there had been some missing documents. There was now a recent photograph and a signed health declaration. The home has a recruitment procedure in place and this would be followed if a new member of staff joined the team. We viewed the overall training record that shows the training attended by the staff team. Individual training records are also completed. The majority of training is provided by the Local Authority. However there are occasions when there are no training places available or courses are not running when staff need to be attending them. We discussed with the staff team accessing training from other external organisations. The Annual Quality Assurance Assessment commented on the need for the staff team to consider looking to improve the training programme. The training that is available and accessed must meet the ongoing needs of the staff team. Staff were out of date with First Aid and some staff needed refresher training in Health and Safety. Subsequent to the inspection visit we were informed that staff had been booked to attend First Aid training and Health and Safety. New staff receive an induction to the home. This was viewed and demonstrated that new staff are informed about how to work in the home. New staff then spend time shadowing permanent experienced staff. This enables the Manager and Deputy Manager to assess when the new member of staff is ready to work alone and unsupervised. Some staff had also attended training on the Mental Capacity Act. The Manager was aware that all staff need to be informed about this new legislation and how this could have an impact on how staff support and work with the residents. Overall staff receive training on the core subjects and more specialist topics such as dementia. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the interests of the residents. Systems are in place to obtain the views of the residents. Overall the current maintenance and servicing checks protect the residents and staff team from harm. Evidence: The Manager has owned the home for over twenty years. He along with his wife, the Deputy Manager, have established a small and well run home for the benefit of the residents. The residents have lived in the home since it was established and therefore the Manager is familiar with the residents needs. The home has systems in place to gain the views of the residents and visitors. Each year residents are supported to complete surveys and visitors are also asked to complete surveys. Residents are also involved in meetings and are asked to contribute Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: their thoughts and ideas about the home. We viewed a quality assurance audit report. This looks at various aspects of the home and records what is in place. The aims and objectives for the home over the next twelve months could also be included into this report and areas for improvement, so that the staff team know what the home is going to be doing over the next year. Maintenance and servicing records were viewed. Fire drills are held on a monthly basis and the fire equipment is serviced on a regular basis. The Manager had completed a fire risk assessment. This was discussed with the Deputy Manager as this was basic and did not fully consider and assess the potential fire hazards within the home. We discussed with staff the benefit of also completing individual risk assessments on residents responding to effectively to a fire. Subsequent to the inspection, we were sent these assessments and informed that the Deputy Manager had attended a one day training course on fire prevention. Other servicing records, such as, Portable Appliance Test, Gas Safety checks and testing for Legionella were all up to date. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 The training programme 30/01/2009 needs to meet the needs of the staff team and consequently the residents. Staff need to be up to date with training on First Aid and Health and Safety. To ensure residents are supported by competent and skilled staff, the training staff need to attend must be accessed on an ongoing basis. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 42 It is recommended for the current fire risk assessment to be reviewed and completed in more detail, in order to fully safeguard the residents and staff team. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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