Inspection on 09/12/05 for Whiteheart Avenue, 3

This inspection was carried out on 9th December 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Whiteheart Avenue, 3 27/10/08

Whiteheart Avenue, 3 24/07/06

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 09/07/2008.

CARE HOME ADULTS 18-65 Whiteheart Avenue, 3 Hillingdon Middlesex UB8 3EP Lead Inspector Ms Pauline Griffin Unannounced Inspection 9th December 2005 12:30 Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Whiteheart Avenue, 3 Address Hillingdon Middlesex UB8 3EP 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) 0208 561 8098 Mr Koosraj Ramaya Unthiah Mr Koosraj Ramaya Unthiah Care Home 3 Category(ies) of Learning disability (0) registration, with number of places Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only service users residing in the home prior to their 65th birthday may be accommodated after their 65th birthday. 6th May 2005 Date of last inspection Brief Description of the Service: The home is situated 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 three Service Users are all male and who 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 Person, the Deputy Manager (wife of the Registered Person) a Senior and three part time Care Workers. The three Service Users attend day centres five days per week and have a programme of activities for weekends and evenings. The Registered Person owns another home for two Service Users with learning disabilities in the same road. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process and the second to take place in 2005. The inspection was carried out with the assistance of the Senior Care Worker during one day, for the duration of 4 1/2 hrs. Both the Registered Person and Deputy Manager were spoken to and the Service Users were observed returning from their respective day centres and eating their evening meal. The Service User group do not converse easily with people they don’t know and their re-actions could only be gauged by their responses to the Staff and their evening routine in the home which were positive ones. The inspection also included the examination of one member of Staff’s file and one Service User’s file (both chosen at random). Other records and logs were examined including minutes of meetings, daily logs and certificates/confirmations of gas, water, fire and electrical appliances. The Service Users had a good calendar of seasonal events arranged for December. The group continues to visit the monthly social event in Southall that has a religious basis. The Deputy Manager said that one Service User collected pictures of the sect leader Sai Baba (of which there were six around the house) and it was discussed as to whether it could be construed that her own interest in the sect could be seen to have an undue influence over the Service Users. What the service does well: The home has a stable Staff team and the Staff were able to describe and demonstrate a detailed knowledge of the Service Users and their needs and preferences. The Registered Person, Deputy Manager and the Senior Careworker have achieved the NVQ level 4 in Care Management and the Care Worker is currently studying for the NVQ level 2. Staff receive training in mandatory subjects and the Registered Person ensures that other training in specialist subjects are accessed for the Staff. The home has good recording systems, policies and guidance that are used in Staff supervision and training. The home is comfortably furnished and homely although the bathroom and some furnishings were in need of attention. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&4 The home has had no new Service Users since it was opened in 1988 but satisfactory procedures and assessment formats are in place that are appropriate both for prospective and the ongoing assessment of existing Service Users. EVIDENCE: The home continues to maintain an individual folder for each Service User that includes a Statement of Purpose, Service User Guide and a signed Contract between the home and the Service User. Service User files include sections on health with details of appointments with health professionals and the outcomes. The Registered Person or Deputy Manager accompanies the Service Users to all health appointments. The files include a daily living plan that give the of contribution the Service User can give to any task. This ensures that any subtle changes are registered and action taken to obtain support. Two of the Service Users had received specialist dental treatment and each had to have several teeth extracted in June 2005. Service Users receive specialist support with regular physiotherapy, speech therapy and psychology consultations through Health Services. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 & 10 Service Users have their Care Plans updated every three months and have a their individual life plan reviewed to assess and address any minor or significant changes. EVIDENCE: The Service Users’ plans and assessments were comprehensive and up to date. The individual life plan or daily living plan, assess the of their own contribution to any everyday task. The home maintains confidences and information in accordance with the Data Protection Act 1998. The home has a policy on confidentiality. Written evidence confirm that confidentiality has been a topic in staff supervision and staff meetings. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15 & 17 Service Users and are offered a range of activities that are appropriate to their age and cultural background. Service Users also choose from a selection of popular well balances meals. Records provide evidence of the choices offered and log the Service Users own preferences to confirm that they have had the opportunity of influencing their day to day lives. EVIDENCE: There is a monthly chart of leisure activities for the group and each Service User has a chart recording their activities as an individual each week. The home has made an effort to improve on the choices of leisure activities offered to the Service Users outside those offered by their Day Centres and evening social clubs. Favourites include, bowling, cinema, Beck Theatre, day trips, shopping and holidays. Day trips and holidays are chosen by the group from brochures. Both the homes join together at times to share leisure activities. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 11 The group had enjoyed a pre-Christmas Salvation Army concert at the Beck Theatre and had chosen the Christmas Pantomime there on the forthcoming Saturday evening. They had also chosen a coach trip to see the Christmas Lights in Regents Street in the following week. The group go to a monthly gathering in Southall connected with the Sai Baba religious following that is part of the Hindu belief. The Deputy Manager said that some of the Service Users buy religious items, rings, a watch and photographs. There are six photographs of the Sai Baba around the home. The Deputy Manager said that these were collected by one particular Service User and there was a discussion as to whether it could be construed that the Deputy Manager’s own religious beliefs had undue influence over the Service Users who are all practicing and non-practicing Christians. The home keeps a menu book and a book of a daily record of what has been eaten by whom. This records when one Service User chooses a different meal from the other two and there were many instances of this. On the evening of the inspection, one Service User was having fish, chips and peas and the other two had chosen fish pie. This was followed by crème caramel desserts. There was a bowl of bananas and tangerines in the kitchen. The Service Users ate the meal together around the large kitchen table and one was assisted to eat by the Care Worker. Their re-action to the meal was enthusiastic. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 20 All of the three Service Users need degrees of prompting and support with their personal care. Care is provided mainly on a ‘same sex’ basis and Service Users are given the choice of who assists them. Medication is well managed in the home and records and medicines were kept in a satisfactory manner. EVIDENCE: The Senior Carer said that the Service Users meet candidates when they are recruited and have the opportunity to say who they prefer. The Senior Carer said that he provides personal care for the two who need more intimate assistance. Service Users choose the clothes they wish to wear and these are laid out for them in readiness usually for the following day. The Service Users appeared neatly dressed, clean and well groomed. Two had quite closely shaven haircuts and the Registered Person said that they had chosen this style at the barbers. None of the Service Users can manage their own medication. Records and stocks of medication are maintained in a satisfactory manner. Medicines are Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 13 stored in a locked cupboard and each Service User’s medicine is kept in separate compartments. Only senior Staff members administer medication. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Service Users have an advocate obtained through the Hillingdon Advocacy Project to ensure their interests are protected independently. The home has policies on Equal Opportunities and Adult Protection and details are posted on the kitchen notice board to ensure that Staff are aware of them. EVIDENCE: The home has a clear policy on the protection of vulnerable adults (POVA) and the Senior Care Worker said that when the Registered Person attended courses, he cascaded the information through supervision and Staff meetings. Evidence of this was seen in the Staff meeting minutes. The Senior Care Worker said he had received training on this subject and the forms abuse could take in his NVQ studies that he had recently completed. The home’s policies were displayed on the kitchen notice board for Staff. There was also a simple pictorial form of complaints procedure for Service Users that included what steps they should take if they had concerns or a complaint. Service Users’ finances were not inspected on this occasion as it was inspected on the previous inspection in May 2005. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25, 27, 28 & 30 The Service Users’ bedrooms were satisfactory and contained plenty of personal possessions. The bathroom has been assessed for equipment by an occupational therapist earlier in the year to ensure safety. The bathroom, however, needs attention to the door and general decorative order and the odour of dampness had returned in the lounge and shared bedroom. EVIDENCE: A tour of the premises was made and the Service Users bedrooms were satisfactory. The shared bedroom has a curtain dividing the twin beds. The two Service Users sharing this room have done so for many years. It was noted that the damp, musty smell had returned in the lounge and shared bedroom. The bathroom door had become very stiff to open and close and the bathroom itself required attention to ensure that the decorative order was improved. Toothbrushes were heaped together and the individual tooth mugs were not clean. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 16 Light coloured mats in the lounge were stained and in need of cleaning or replacement. The size of the communal space in the home is satisfactory and there are private Staff facilities in a separate part of the home. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 36 The Service Users’ benefit from well trained Staff who receive regular supervision with the Registered Person. EVIDENCE: The Staff have job descriptions that set out their roles and responsibilities. The Senior Care Worker interviewed, was clear about the aims of the home and the role he played within the Staff structure. The Senior Care Worker described the training and support he received in supervision from the Registered Person. The Senior Care Worker provides one to one supervision with the Care Worker. Supervision takes place every eight weeks and is signed and dated. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41 & 43 The home operates a Person Centred Planning system that is updated every three months or more regularly if the situation requires it. Records confirmed that Service Users’ contribute to the assessments. The home continues to provide evidence that Service User’s rights and views are incorporated at all levels of the service. EVIDENCE: The Registered Person and the Deputy Manager are both from nursing backgrounds and have nursing qualifications. The have both achieved the NVQ level 4 in Care Management. The Registered Person undertakes regular mandatory and specialist training. Quality monitoring questionnaires have been sent to the key workers in the Day Centres but these have not yet been collated with other forms of quality monitoring. The quality assurance programme has still to be formulated to include all strands of available feedback to measure the service provision. The annual overview of the quality review must be forwarded to the CSCI. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 19 The policies and procedures of the home are satisfactory and are updated annually and signed by the Registered Person. Record keeping in the home is well maintained, up to date and comprehensive. The home has an annual budget and breakdown for each cost centre. The Registered Person submitted trading accounts to the Care Standards Commission for years 2002/3. Insurance cover is for employers liability 10 million, public liability 5 million and medical malpractice 5 million. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 3 x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 x 2 3 x 2 LIFESTYLES Standard No Score 11 x 12 x 13 2 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 x x x x 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Whiteheart Avenue, 3 Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 x 2 3 3 x 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 21 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 1 Standard 27 27 Regulation 23(2)(d) 23(2)(b) Requirement The bathroom is in need of redecoration. The bathroom door must receive attention to ensure that it opens and closes without the need for force caused by dampness. Toothbrushes must be kept in an hygienic manner. Each person’s toothbrush must be kept separately. The smell of dampness has returned to the lounge and back bedroom. A quality monitoring system must be completed and include all strands of information available to measure the service. An overview of the results must be forwarded to the CSCI annually. Timescale for action 01/02/06 06/01/06 3 30 16 (2)(j) 06/01/06 4 5 30 39 23(2)(b) 24 01/02/06 01/02/06 Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 13 Good Practice Recommendations Religious observances should be maintained appropriately with regard to the cultural background of the Service User Group. Whiteheart Avenue, 3 DS0000027094.V261243.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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