Care Home: 19-21 Haymill Close.

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What the care home does well The home provides a service to people of different cultural and religious background and is reflected in a diverse staff group. The separate needs and aspirations of prospective residents are being comprehensively assessed prior to admission. Care plans are clearly and appropriately drawn up and regularly reviewed. Residents are able to make decisions regarding their daily living routines and are supported during shared and/or individual activity within the community. Varied and nutritional cooked meals are provided. The physical and emotional health care needs of people who use the service are being met satisfactorily and their safety and welfare are safeguarded. Support workers are suitably trained and qualified and were competent and attentive in meeting the needs of residents. People were appropriately dressed and appeared well cared for, settled and content. Overall, the home was clean, hygienic and well maintained. The environment was bright, airy, calm and homely. What has improved since the last inspection? Three requirements made at the last inspection had been complied with. These related to records, issues relating to the environment and fire safety tests. A separate respite care service is currently being provided. What the care home could do better: Two requirements regarding the Statement of Purpose and recruitment documents were identified at this inspection. The Registered Person must ensure that the Statement of Purpose is updated to incorporate changes that have been implemented within the service. Copies of all staff recruitment documents must be held confidentially at the home. CARE HOME ADULTS 18-65 19-21 Haymill Close 19-21 Haymill Close Greenford Middlesex UB6 8HL Lead Inspector Jean Bovell Unannounced Inspection 27 August 2008 4:00 th 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 19-21 Haymill Close Address 19-21 Haymill Close Greenford Middlesex UB6 8HL 020 8998 8707 020 8810 9531 hm1921haymill@ealing.org.uk www.supportforliving.org.uk Support for Living 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) Mr Stuart McQueen Care Home 9 Category(ies) of Learning disability (9) registration, with number of places 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to include MD and LD with Physical Disabilities up to 9 in total 10th November 2006 Date of last inspection Brief Description of the Service: 19/21 Haymill Close is a care home registered for adults with learning and/ or physical disabilities. The service is managed by Support for Living, an organisation which manages a number of similar services in the local area. The building is owned by a housing association. The home is two houses joined in the middle by a small office. The bedrooms are single and there is a large communal garden to the rear of the property, with parking to the front. Twenty four hour care and support is being provided to three people with learning and/or physical disabilities number 21. Number 19 has been converted into a respite unit and provides a service to a total of twenty-six people. Of these, a maximum of three are offered a service at any one time and for periods ranging from two hours to three weeks. At the time of the inspection, the Registered Manager for the whole service was on extended leave and an Acting Manager had been appointed at each house. The home is situated off a main road on a residential estate. The main road has public transport links to Ealing Broadway for shops and local leisure facilities. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is TWO STARS. This means that the people who use the service experience GOOD quality outcomes. This inspection was carried out between 4:00pm and 6:30pm on 27th August 2008 and between 10:30am and 6:00 pm on 10th September 2008. During the course of the inspection, records, documents, policies and procedures maintained by the service were viewed. A tour of the premises was undertaken and observations were made. Two Acting Managers, five support workers and two residents were spoken with. The requirements that were made at the last inspection and all key Standards were examined. A completed annual quality assurance assessment – self assessment document was considered. What the service does well: The home provides a service to people of different cultural and religious background and is reflected in a diverse staff group. The separate needs and aspirations of prospective residents are being comprehensively assessed prior to admission. Care plans are clearly and appropriately drawn up and regularly reviewed. Residents are able to make decisions regarding their daily living routines and are supported during shared and/or individual activity within the community. Varied and nutritional cooked meals are provided. The physical and emotional health care needs of people who use the service are being met satisfactorily and their safety and welfare are safeguarded. Support workers are suitably trained and qualified and were competent and attentive in meeting the needs of residents. People were appropriately dressed and appeared well cared for, settled and content. Overall, the home was clean, hygienic and well maintained. The environment was bright, airy, calm and homely. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose was not available for viewing. The needs and aspirations of prospective residents are comprehensively assessed prior to admission. EVIDENCE: A copy of the Statement of Purpose was not accessible at the time of the inspection. The personal files of seven people, four of whom received a respite service, were inspected at random. Each file contained documented evidence that assessments including background history of prospective residents were submitted by the placing authority at the point of referral. It was indicated, also, that a comprehensive assessment was subsequently carried out by the home and that relatives, social workers and health care professionals, where appropriate, were involved 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 9 in the process of determining the capacity of the service to meet separate identified needs and aspirations. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The changing needs of people who use the service are being appropriately assessed and risk assessments are carried out. People are encouraged to make decisions regarding their daily routines. EVIDENCE: Care plans that had been drawn up for three residents and four people who receive respite care were inspected at random. These reflected that the changing personal, healthcare and social needs of people were being assessed and that action plans and six monthly and long term goals were in place. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 11 All care plans viewed were clearly detailed and there were indicators that people who used the service were involved in the drawing up of separate care plans. Risk assessments associated with specific activities identified within care plans had been undertaken. These included moving and handling, eating and drinking, behaviour analysis, violence, absconding and fire and evacuation. Measures for working with residents in potentially difficult situations such as distress and/or tiredness, unknown agency staff and expectations, were also in place. All care plans and risk assessments viewed were regularly reviewed. We were informed by an Acting Manager and also by support workers, that people who used the service were non-verbal or had minimal speech. Pictures, gestures, options and body language were used in encouraging residents to make decisions regarding meals, activities, personal purchases and what they wore each day. Residents with capacity were seen moving freely around the house and garden, and individual choices and interests were reflected in separate bedrooms. Specific identifiable bedrooms were provided to people who received regular overnight, weekend or block periods of respite care. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The religious needs of people who use the service are being met and they are able to participate in a variety of activities within the community. Contact with relatives and/or friends are encouraged and facilitated. Residents receive assistance with carrying out appropriate housekeeping tasks. Varied and nutritional cooked meals are being provided. EVIDENCE: The social interests of permanent residents and those who received respite care were identified within care plans and separate activities programmes were in place. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 13 It was indicated that people of different religious faiths were supported while attending Church services on a Sunday. Birthdays were celebrated and activities within the community included walks, drives, evening clubs, meals out and bowling. Annual holidays were also arranged. A support worker confirmed that everyone who received respite care attended the day centre. People were seen being involved in individual activity in separate bedrooms, walking in the garden, and playing board games or chatting with care staff in communal areas. One resident attended the day centre. A support worker confirmed that everyone who received respite care also attended the day centre. We were informed by an Acting Manager that contact with relatives and/or friends were encouraged and facilities, and that several residents received regular weekly visits. Although people who used the service lacked capacity to assist effectively with housekeeping tasks, support workers reported that residents were able to sit in the kitchen while meals were being prepared and received assistance or supervision while making drinks or tidying individual bedrooms. There are two separate kitchens at the home and sufficient quantities of fresh, frozen and dried foods were stored appropriately. Meals are prepared by care staff and menus were reflective of varied and nutritional meals including vegetarian options being offered. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service receive assistance with their personal care needs as required and their physical and emotional healthcare needs are being met. Policies and procedures on medication are satisfactory. EVIDENCE: The people who use the service require assistance with their personal care routines and specific personal care needs are identified within separate care plans. Support workers confirmed that people’s privacy and dignity were respected. Those with capacity were able to dress themselves and everyone was offered choice regarding the clothing they wore each day. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 15 The changing health care needs of residents were also reflected within individual care plans. It was indicated that people received access to healthcare professionals as and when required and were accompanied to medical appointments. Drama and massage therapies and reflexology were also regularly provided. Medication kept at the home included those that were prescribed to people who received respite care. All medicines were safely and appropriately stored, accurately recorded and signed after being administered. We were informed by support workers that people who used the service lacked capacity to self-administer their medication. The records were indicative of medication training being delivered to care staff and was confirmed by support workers spoken with. Policies and procedures on medication were in place. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is satisfactory and people are being protected from abuse and neglect. EVIDENCE: The complaints procedure was clearly written and illustrated in a format suitable to meeting the needs of people who use the service. The complaints books were viewed. It was reflected that three complaints were made following the last inspection and all had been satisfactorily investigated and resolved. An Acting Manager confirmed that residents received state benefits and that personal cash allowances were held in safekeeping at the home. ‘Pocket money’ belonging to those who received respite care was also secured. Separate financial records were inspected but no discrepancies were identified. Accident and Incident records were being maintained. Regulation 37 forms were submitted to the CSCI as required. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 17 The records were reflective of staff training on the Protection of Vulnerable Adults being delivered. Policies and procedures on safeguarding adults were in place. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Bedrooms are suitably furnished and personalised. Bathroom and toilet facilities are appropriate for meeting the personal needs of people who use the service. People are assisted by specialist equipment. The home is well maintained and the environment is safe and homely. EVIDENCE: Communal areas within the premises are spacious and suitable for wheelchair users and also for shared and/or individual activity. All furnishings are appropriate, comfortable and are of good quality. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 19 Kitchens and laundry rooms contain the required fittings and equipment. All bedrooms are suitably fitted and furnished and reflect personal choices and interests. The bathroom and/or toilet facilities are sufficient and appropriate for meeting the personal needs of all the people who use the service. A variety of specialist aids for maximising independence are in place. These include grab rails, wheelchairs, zimmer frames, walkers and adjustable baths. The gardens are well maintained and accessible to wheelchair users. Overall, the home was clean, hygienic and well maintained. The environment was bright, airy, calm and homely. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are excellent and support workers are suitably trained and qualified for meeting the needs of the people who use the service. Staff recruitment files do not contain copies of all required documents. EVIDENCE: It was reflected on staff rotas that a total of 15 permanent support workers were employed within the residential and respite units. Each unit was covered by two or three support workers during waking hours and two waking staff at night. We were informed by an Acting Manager and indicated on the annual quality assurance assessment (AQAA) that a total of seven support staff, including seniors, had achieved NVQ qualification in level 2 or above. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 21 Separate training records were in place and reflected that new support workers received induction training. Subsequent training and refreshers delivered included Disability Awareness, Challenging Behaviour, Epilepsy and Safe Administration of Rectal Diazepam and Moving and Handling. The Acting Managers confirmed that original recruitment documents were held at Head Office but copies were stored confidentially at the home. A total of eight staff files were viewed at random but none contained copies of all required documents such as photo-identification, references, application forms and signed contracts/statement of terms and conditions. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Acting Managers are suitably trained and qualified. Annual quality assurance has been effectively undertaken. The health, safety and welfare of people who use the service are being protected. EVIDENCE: 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 23 The Registered Manager of the Service was on extended leave at the time of the inspection. He was being temporarily replaced by two Acting Managers and both were appropriately qualified and experienced. Support workers that were spoken with reported that both Acting Managers were approachable and supportive. An annual quality assurance assessment document was completed satisfactorily and submitted to the CSCI as required. Health and Safety records were up-to-date. These included checks for fire safety and portable appliances. Regular fire drills were being undertaken and environmental risk assessments were in place. There was documented evidence that staff training on Health and Safety, Fire Safety, Food Hygiene and First Aid had been delivered. 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 24 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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 19(4)(b) Requirement The Registered Person must ensure that copies of all recruitment documents are held confidentially at the home and are available for inspection. The Registered Person must ensure that all changes within the service are reflected in the Statement of Purpose. Timescale for action 30/11/08 2. YA1 4 1)(a)(b) 30/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 19-21 Haymill Close DS0000027739.V366232.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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