Inspection on 27/10/08 for Whiteheart Avenue, 3

This inspection was carried out on 27th 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, 3 24/07/06

Whiteheart Avenue, 3 09/12/05

Whiteheart Avenue, 3 06/05/05

Whiteheart Avenue, 3 23/11/04

Whiteheart Avenue, 3 17/05/04

Whiteheart Avenue, 3 30/01/04

Whiteheart Avenue, 3 11/08/03

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 17/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Whiteheart Avenue, 3 Whiteheart Avenue, 3 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: 2 7 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 25 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 25 Information about the care home Name of care home: Address: Whiteheart Avenue, 3 Whiteheart Avenue, 3 Hillingdon Middlesex UB8 3EP 02085618098 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 The home is a house in a quiet residential avenue 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 long period of time. The two residents are male and have lived in the home since it was opened in 1988. The property is a bungalow that has been extended. It has a twin bedroom, a single bedroom, lounge and a kitchen/dining room. There is a staff team consisting of the Registered Manager, the Deputy Manager, who is the wife of the Registered Manager and support care staff. The two residents attend day centres and have a programme of activities for weekends and evenings. The Registered Manager Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 3 Brief description of the care home owns another home for two people with learning disabilities in the same road. The current fees for this service are £491.00 per resident, per week. Care Homes for Adults (18-65 years) Page 5 of 25 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 home last had a key inspection on the 24th July 2006. We carried out this inspection from 11AM-4.50 PM. We looked at various documents, such as one residents files, one staff employment file and a sample of servicing and maintenance records. The Registered Manager will be referred to in this inspection report as the Manager. The Manager had completed an Annual Quality Assurance Assessment and this formed part of the inspection process. The two residents living in the home were spoken with as part of the inspection process. Care Homes for Adults (18-65 years) Page 6 of 25 The Manager was present for some of the inspection with the Deputy Manager assisting with the majority of the inspection visit. All of the four previous requirements had been met. One new requirement was made. All of the key National Minimum Standards were assessed. 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 25 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 25 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. A prospective residents needs would be assessed prior to moving into the home. Evidence: The home has not admitted any new residents for many years. There is currently one vacancy in the home. We were informed that the home has a pre-admission process in place. Prospective residents would be assessed prior to moving into the home and would have the opportunity to visit the home in order to meet the other residents and staff team. The Deputy Manager is aware that the home needs to carefully consider any prospective resident, as the other two residents have lived together for many years. Care Homes for Adults (18-65 years) Page 10 of 25 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. The needs of the residents are recorded and were being met. Residents are supported to make every day decisions about their lives. Residents risks are assessed and where possible, minimised. Evidence: We viewed one residents file. The Deputy Manager completes the care plans and risk assessments. The care plan viewed contained detailed information about the residents personal, social and care needs. Residents abilities and preferences were also noted. It was clear where the resident needed full support, encouragement and prompts from the staff team. Some evidence was seen that the resident had been part of the development of their care plan as they had signed it. There was a summary of the care plan that also provided an overview of the resident. The Annual Quality Assurance Assessment stated that the changing needs and goals of a residents are recorded in Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: their individual care plans. The residents final wishes had also been considered and recorded. A sample of the daily records were seen and these recorded what the resident had done each day and any other significant events. We were informed that the Manager had been trying to find independent advocates for the two residents, but the local organisation did not have any advocates available. Residents are not able to handle their own finances. One resident is able to, with support, travel locally without a member of staff. This resident, once familiar with a route, can access some local resources on public transport, such as the library and shops. Staff encourage the residents to make daily decisions about their lives. We spoke with the residents, who are verbal and can voice their thoughts and opinions. We viewed the risk assessments. These outlined the assessed potential risks and recorded ways to minimise these risks, for example, travelling on public transport. The Deputy Manager explained that staff had taken measures to minimise the risk of this resident getting lost. For example, as stated above, staff show the resident the route to take and the buses to use to get to the local town. We spoke with this resident who confirmed the route they would take to get to College. Overall the documentation viewed provided a clear picture of the resident and their individual needs. Where the residents needs change, the care plans and risk assessments are updated accordingly. Care Homes for Adults (18-65 years) Page 12 of 25 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 activities both in and outside of the home. Residents are encouraged to maintain contact with family and friends. The rights of the residents are respected. The meal provision provides the residents with a nutritious and varied diet. Evidence: The two residents attend local day centres. Both attend five days a week, with one resident attending a local College one day a week. One resident is not able to use public transport and staff support this resident to access places of interest in a member of staffs car. Day trips and a holiday had taken place this year. The Manager Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: and Deputy Manager had taken the two residents, with two other residents, who also live in a care home owned by the Manager, on a weeks holiday. One resident spoken with said they had enjoyed going on holiday. Residents are supported to take part in things that interest them, such as going to church or reading a book. The staff are mindful that the residents are over sixty years of age and are busy during the weekdays. Therefore more leisurely activities are on offer in the evenings and week-ends. Staff support residents to maintain contact with relatives. One resident occasionally speaks with their relative on the telephone. The Manager ensures that relatives are kept informed if anything significant happens to the residents. The Annual Quality Assurance Assessment commented that due to the age of the residents, family and friends could be encouraged more to visit the home. The residents receive their personal mail, although only one resident can read some words. The two residents share a bedroom. The Deputy Manager explained that they had done this for many years and that it was their choice. We spoke with one of the residents, who said they liked sharing a bedroom. There is a curtain down the middle of the bedroom, if one of the residents wants to have some privacy. Residents can lock their bedrooms. Staff were seen during the inspection visit, to speak with the residents in a caring and sensitive manner. A sample of menus were viewed. Overall these were traditional meals, although one resident said they liked to eat Chinese food. Alternatives to traditional English food was seen on the menus. Fresh vegetables were seen in the fridge and the evening meal had a selection of fresh vegetables. Residents, where able, are supported to make drinks and small snacks, such as making the sandwiches for the day centre. Staff are aware that the residents need support to ensure they receive a well-balanced diet. Care Homes for Adults (18-65 years) Page 14 of 25 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 receive personal care support in their preferred way. The residents health needs were recorded and were being met. To protect the welfare of the residents, the home has robust medication systems in place. Evidence: Both residents need assistance with managing their personal care. It was noted on the residents file viewed, that they did not have a preference regarding receiving support from either a male or female member of staff. One resident has physical impairments and had difficulties getting into the bath. We saw that an electric chair had been obtained following on from an Occupational Therapist assessment. This now enables the resident to have a bath in a safe way. Both residents have a GP and see other health professionals such as the dentist and chiropodist. Health appointments are recorded along with the outcome of the visit. One Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: resident has recently been diagnosed with a particular need. The Deputy Manager is aware that staff will need to be vigilant when caring for this resident and is mindful that their needs could change gradually over a period of time. We viewed the medication systems in the home. The medication is locked in a kitchen drawer. There were no controlled drugs in the home. Residents are not able to selfmedicate. Usually the Deputy Manager administers medication to the residents, with the senior member of staff witnessing this task. The senior member of staff, who has worked in the home for approximately five years, had not received any formal medication training. The Deputy Manager explained that she had fully informed the senior member of staff about how to handle and administer medication. We discussed the importance and significance for all the members of staff, who at times might be left in charge of administering medication, to receive up to date and relevant training on this subject. During the inspection the Manager arranged for the senior and new member of staff to attend medication training via the Local Authority. We counted and checked the medication for one resident. All eight medications counted were correct at the time of the inspection. The Deputy Manager counts and checks all the medication once a month and evidence of this was seen. Care Homes for Adults (18-65 years) Page 16 of 25 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. Residents can feel confident that their complaints and concerns would be listened to and acted on. The home has systems in place to safeguard the residents from abuse. Evidence: The home has had no complaints. The complaints policy is visible on the notice board in the kitchen/dining area. One resident spoken with said they would speak with staff if they were unhappy. There have been no safeguarding referrals or investigations. We were informed that the home has their own policy and the Local Authoritys policy and procedure on safeguarding. We counted one residents personal money. This is counted and checked by the Deputy Manager once a week. The money was correct at the time of the inspection. Residents go with staff to withdraw their money and all financial transactions are recorded and receipts are obtained. Care Homes for Adults (18-65 years) Page 17 of 25 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 the home is well-maintained and provides a homely place for the residents to live in. Evidence: The home has had several improvements made to the environment. A new kitchen had been fitted and the kitchen floor had been replaced. One of the residents was keen to point the new kitchen flooring out to us. The bathroom tiles had been painted, although the bathroom suite is old and would benefit from being updated and replaced. The outside of the home had been painted and overall the home was clean and tidy. The staff keep the home clean and the Manager should ensure that the general maintenance of the home is monitored and updated as and when necessary. Care Homes for Adults (18-65 years) Page 18 of 25 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 competent and work together in the interests of the residents. There are robust recrutiment procedures in place to protect the welfare of the residents. Overall residents are supported by staff who receiving ongoing training. Staff and consequently residents would benefit further if staff had fire awareness training. Evidence: We viewed the rota. There is usually one member of staff working and supporting the two residents. This is flexible, as additional staff can work if residents need one to one support. The Manager and Deputy Manager live around the corner from the home and are available to assist the other members of staff. The staff team comprises of four members of staff. This includes the Manager and Deputy Manager. The senior has NVQ level 4. Overall the staff team is stable and there is an awareness of each residents individual needs. The Deputy Manager showed a particular understanding of the abilities and preferences of the two residents. Team meetings are usually held in the evenings when the residents are at home. This Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: was discussed with the Deputy Manager, who explained that residents also might contribute to these meetings. Residents meetings can be a useful way to gain the views of the residents. However staff need time when they are not distracted and when they can also express possibly confidential information, without residents being nearby and potentially overhearing conversations. The Deputy Manager acknowledged that having team meetings during the day, when the residents are out, could prove beneficial for all concerned. This will be considered and discussed with the other members of staff. Overall the Deputy Manager said the team worked well together. We viewed one staff employment file regarding the newest member of staff. All required documentation was obtained, such as Criminal Record Bureau Check, two references and full employment history. The member of staff was new to care work and the Deputy Manager explained that she had taken several months to ensure the member of staff had gained sufficient knowledge and skills to work and support the residents sucessfully. We followed this on by looking at the induction and training attended by this new member of staff. They had received an in-house induction and evidence was seen that they had shadowed different members of staff. We discussed with the Deputy Manager looking at the Skills for Care induction, which is more detailed and could be used for new members of staff, in particular when they are new to care work. An overall training plan and individual training records were seen. Staff had attended some core training such as food hygiene, dementia and moving and handling. No staff, other than the Deputy Manager had attended fire awareness. This was discussed with the Deputy Manager and is a requirement for all staff to be fully trained and aware of issues regarding fire prevention. The Annual Quality Assurance Assessment acknowledged that there needed to be more consultation with training providers in order for the home to improve its standards. Care Homes for Adults (18-65 years) Page 20 of 25 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 by a competent and supportive Manager. Systems are in place to obtain the views of the residents. The residents live in a home that is safe and well-maintained. Evidence: The Manager has owned the home for over twenty years. He, along with the Deputy Manager has obtained an NVQ level 4 and 5. The Manager has a visible presence in the home and works closely with the other members of staff. The home has various systems in place to obtain the views of the residents and visitors. Surveys are completed, staff have to support residents to complete the surveys. A summary report was seen that is completed each year. This looks at various areas of the home and records what is in place. Shortfalls are recognised and worked on over the forthcoming months. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: We viewed a sample of maintenance and servicing records. The Gas safety and Portable Appliance Test were up to date. The Manager had completed individual risk assessments on each resident to record how they would respond in the event of a fire. A basic overall fire risk assessment had been completed. This needed to be completed in more detail and subsequent to the inspection we were sent a more detailed version. This assessment needs to be checked and updated as and when risks are identified by the Manager. Fire drills are held on a monthly basis to ensure staff and residents know how to respond in the event of a fire. Overall the equipment is regularly tested and checked and the safety of the residents are considered by the staff team. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 In order for residents to be supported by skilled and informed staff, staff must attend training on fire awareness and fire prevention. To protect the welfare of those living in the home. 27/02/2009 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 The fire risk assessment should be detailed and relevant to current fire legislation and to the needs of the home and residents. Care Homes for Adults (18-65 years) Page 24 of 25 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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