Inspection on 09/01/06 for Woodlawn Crescent

This inspection was carried out on 9th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Woodlawn Crescent 10/10/07

Woodlawn Crescent 13/09/06

Woodlawn Crescent 22/09/05

Woodlawn Crescent 13/01/05

Woodlawn Crescent 27/05/04

Woodlawn Crescent 05/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Woodlawn Crescent 8-10 Woodlawn Crescent Whitton Middlesex TW2 6BE Lead Inspector Sandy Patrick Unannounced Inspection 9th January 2006 10:00 Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Woodlawn Crescent Address 8-10 Woodlawn Crescent Whitton Middlesex TW2 6BE 020 8893 4948 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) h4mo67rusted@mencap.org.uk www.mencap.org.uk Royal Mencap Society Ms Elizabeth Rusted Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2005 Brief Description of the Service: 8-10 Woodlawn Crescent is situated in a quiet residential road in Whitton. The premises are owned by Richmond Churches Housing Association. The home is managed by MENCAP, a charitable organisation. The home is registered for four service users who have a learning disability. The home is a bungalow, designed to accommodate service users who have a physical disability. Service users access local community facilities and attend local resource centres. They are also supported by staff from the home to develop and maintain community living, domestic and personal skills. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 9th January 2006, and was unannounced. The Manager was present throughout the inspection. The Inspector met with staff on duty, however, no service users were at home at the time of the inspection. The Inspector was made welcome by staff. On the day of the inspection a new member of staff was undertaking her induction, supported by the Deputy Manager. The Inspector was able to discuss the procedures around this with these staff. What the service does well: What has improved since the last inspection? Service users have had their own individual achievements. The staff have worked hard to support service users through changing health needs and have advocated on behalf of service users when needed. Two new staff have been employed. There have been improvements to medication practices. There have been improvements to the way in which money belonging to service users is recorded and managed. The Manager has taken on responsibility for line managing three other Mencap homes on a temporary basis. The Manager continues to work at Woodlawn Crescent and the Deputy Manager has taken on additional management responsibilities at the home in order to offer support. The Manager and Deputy Manager feel that this has not had a detrimental impact on the way in Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 6 which Woodlawn Crescent is managed, but has enhanced both their skills and knowledge. 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. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 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 Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 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): 1&3 There is a range of information about the home available to service users. EVIDENCE: The Manager reported that the Statement of Purpose and Service User Guide had been updated since the last inspection to include new information. These documents are available for potential and existing service users. There was one service user vacancy at the time of the inspection. There are no service users due to move in to the home in the near future. The Manager has liaised with Care Managers about possible referrals for the service user vacancy. The admission procedure includes an assessment of needs and opportunities for the service user to visit and stay at the home. The home is registered to provide a service for up to four people. Those living at the home have a range of complex needs, including differing health care, dietary, mobility and sensory needs. Service user plans reflect assessed needs. The staff works in partnership with the Community Team for Learning Disabilities who offer support and advice. Staff receive training in relation to their work at the home. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 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&9 Individual needs are recorded and monitored and staff have a good understanding of these. EVIDENCE: Individual service user plans are in place for all service users. These record needs and wishes and include guidelines and information from other people who work with the service user. At the time of the inspection, there were some significant changes in health care needs for some service users and staff were focusing time on making sure these were met. The Deputy Manager reported that they plan to introduce person centred health care and medication plans. This will help service users to better understand and express these needs. It is important that the Manager and staff consider how best to further promote person centred planning and develop accessible information in all areas. A new format for risk assessments is being introduced to Mencap homes. The Manager said that staff were transferring information onto these. The assessments look at the benefits and risks involved in each activity. There is a Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 10 range of assessments at the home which are kept under regular review. These include information from health care professionals where necessary. Staff keep daily records in order to monitor health and personal needs. These are used to help service users to plan the care they need with staff. Staff on duty demonstrated a good knowledge of individual needs and how best to meet these. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15 & 17 Service users are supported to develop and maintain life skills and to make decisions about activities, education and relationships. Service users are involved in the planning, shopping for and preparation of food. EVIDENCE: Over the past year there have been changes to the care and support of some of the service users to reflect changes in their needs. Service users have individual activities arranged to meet their specific needs. For some service users, this includes attending colleges and resource centres. Service users are also supported by staff to use the local community and to travel to other places. Some service users have tried new activities in recent months, such as pottery, and they have enjoyed this. Service user’s needs and wishes are reviewed on a regular and ongoing basis. Staff support them to meet these and the way they do this is flexible, so that service users can make choices and express themselves. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 12 Service users are supported to meet their leisure needs as individuals and as a group. Records of care and support indicate that service users pursue a variety of interests. Service users are supported to maintain close links with families and friends. Manager said that staff have worked closely with families as the needs of service users have changed, so that service users feel supported by the various people who are important to them. The home caters for specialist diets, one diet is a result of a health need and must be strictly followed. Appropriate procedures are in place to ensure that the dietary needs of this service user are met, and choice is not compromised for others. Highly detailed information on what all service users can and cannot eat is available for staff within the kitchen. Monitoring charts are in place to make sure all service users’ nutritional needs were met. Some of these were in pictorial form and this supports the service users to understand them. The Inspector saw a sample of menus for the home. These were varied and indicated nutritionally balanced diets. Food is appropriately stored and is fresh and in adequate supply. The kitchen was clean and hygienic. Service users participate in food preparation if they wish to. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20 Service users health care needs are appropriately recorded, monitored and met. Staff have advocated on behalf of service users and helped them to make decisions about their own health. There is an appropriate procedure for the administration of medication and this is followed. EVIDENCE: storage, recording and The Manager and staff demonstrated a very good knowledge of individual service users’ health needs. Some of these health needs have changed over the past year. The staff at the home monitor these closely and have worked with health care professionals to make sure that these needs are met. The Manager and staff have advocated for service users regarding their health care needs and have supported service users to make their own decisions. The support that staff have given to service users at this time is commendable. They have appropriately consulted and shared decision making with all parties but have put the service users’ rights and choices first. They have worked hard with the local Community Team to support service users to understand the choices they are making and have been proactive in seeking advice and guidance from relevant parties. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 14 There are thorough records relating to health care needs and how these should be monitored and met. The staff approach is consistent and is designed so that service users feel that they can trust the staff to meet these needs and represent their wishes. Since the last inspection the Manager has reviewed the medication procedure. Staff now make regular checks on stock medication. Medication was appropriately stored and recorded. The staff are working with service users to develop individual health care and medication plans which they will find easier to understand. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 There is an appropriate complaints procedure and all complaints and concerns are recorded. There are appropriate procedures to promote protection of service users. EVIDENCE: There is an appropriate complaints procedure, detailing timescales and information on how to contact the Commission for Social Care Inspection. There have been no complaints since the last inspection. The Manager keeps a record of all informal complaints and concerns and any action taken. The home has adopted the local authority Protection of Vulnerable Adults Procedure. Mencap has its own procedures on abuse and whistle blowing. All staff have relevant training and this is part of the induction package. There are clear procedures to offer service users support to manage their finances and make rent payments. Small amounts of cash are held securely at the home. Since the last inspections there have been improvements to the way in which service users’ money is recorded and checked. Daily checks on all money held are made by staff on duty and the Manager or Deputy Manager audit these weekly. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30 The environment is suitably equipped, furnishes, maintained and decorated and meets the needs of the service users. EVIDENCE: The building is a single level bungalow. It is owned by Richmond Churches Housing Association. All rooms are for single occupancy. There is a large lounge/dining area and an accessible kitchen. There is one bathroom and one shower room and a separate WC. The home is attractively decorated throughout and appropriately maintained. The garden is well maintained and attractive. Communal and private rooms are appropriately furnished. Picture, photographs and plants throughout the home add to the welcoming and comfortable atmosphere. The Manager reported that there are no significant environmental needs and that minor areas of maintenance were attended to appropriately. Two bedrooms are under 10sq.m, although there is additional communal space to compensate for this. The Registered Persons should consider the lack of space in two rooms when admitting service users in the future, especially if equipment is required, because this would restrict space further. The house has been adapted to be wheelchair accessible. There are low-level surfaces in Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 17 the kitchen. There is a range of specialist equipment throughout the home, in The Physiotherapist works communal and private areas and bathrooms. closely with the home to assess and meet equipment needs. Evidence of this was seen in service user plans. Corridors and bathrooms have been equipped with handrails as required. The shower is accessible for all service users. The home was clean and hygienic throughout on the day of the inspection. There are appropriate procedures for ensuring infection control, Control of Substances Hazardous to Health, disposal of clinical waste and laundering of clothes. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 There are appropriate procedures for the recruitment, support, training and induction of staff. There is a good range of information for staff on the needs of the service and their roles and responsibilities. EVIDENCE: Two new members of staff started work at the home shortly before the inspection visit. One of these new staff members was on duty and spoke with the Inspector. They said that they were being well supported to learn about the needs of service users and the routines of the home. The Deputy Manager was supporting the new member of staff to find out information on the day of the inspection. They told the Inspector that there was a detailed two week induction plan which the staff undertook before they worked alone with service users. There is a comprehensive file of information about the home which is designed as a reference guide for new and temporary staff. There is one part time vacancy at the home, but the Manager does not intend to recruit to this position until a decision has been made about the service user Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 19 vacancy. Vacant shifts are covered by staff over time and two regular peripatetic staff, who know the service users well. The Manager has worked closely with funding authorities to reassess staffing needs and additional temporary staffing has been provided to supports service users with changing health care needs in the short term. Staffing needs will be reassessed on a regular basis. There is a thorough programme of training for all staff, including key training throughout the induction. Training in specialist needs been organised to support staff to have a better understanding of these needs. Staff are supported to undertake NVQ training relevant to their role. The Manager praised the staff team for their hard work and support of service users over recent months. The recruitment files for the two newest members of staff were examined. These were complete and evidenced through checks. Records of the recruitment interviews were kept on file. Monthly team meetings are held and staff are able to contribute their ideas and opinions. Regular supervision and annual appraisal meetings are held with each staff member’s line manager. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 20 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, 41, 42 & 43 The service is appropriately managed by a suitably experienced and qualified person. Appropriate checks are made and recorded on the health and safety of the home. EVIDENCE: In December 2005 the Manager took on additional responsibilities line managing three other local Mencap homes on a temporary basis. She continues to manage Woodlawn Crescent, supported by the Deputy Manager. The Manager told the Inspector that she was enjoying these extra responsibilities and found it a useful learning experience. The Deputy Manager has a good knowledge of the home and is able to provide support and management to cover any absences of the Manager. The Manager works closely with other professionals and is proactive in asking for support and advice when needed. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 21 The staff at the home use the computer and email system on a regular basis. There is no broadband connection and the staff expressed frustrations at the limitations of the current dial up system, which often fails to work properly. The organisation should consider installing broadband at the home to improve communication systems. The Manager reported that the Area Manager was supportive and was going to work with her to develop the home’s budget for the coming year. There is evidence of regular checks on health and safety, including fire safety, Control of Substances Hazardous to Health, electrical, water and gas safety. Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 4 3 X 3 X X X 3 3 3 Woodlawn Crescent DS0000017399.V261220.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 YA6 Good Practice Recommendations The Registered Person should give consideration to developing accessible information and further promoting person centred planning. 2. YA41 The Registered Person should consider installing broadband at the home to support better communications and access to the internet and email services. 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