Care Home: 198, Powder Mill Lane

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What the care home does well Provides a stable staff and management team that knows residents` needs well. Provides excellent healthcare and makes sure that residents have access to appropriate treatment when they need it. Identifies changes in residents` needs and responds appropriately. Works well with other professionals in delivering care. Provides opportunities for residents to access a range of social and leisure activities. Promotes residents involvement in their local community. Support residents to maintain relationships with their friends and families. Provides a varied and well-balanced diet that meets residents` individual needs. Keeps and shares information about residents appropriately. What has improved since the last inspection? Residents` Health Action Plans have been updated. The garden has been improved by the addition of more plants, furniture and equipment. Some of the fixtures and fittings have also been replaced since the last visit and some parts of the home have been redecorated. The home has a new vehicle, which is larger than the previous one and can accommodate wheelchairs. CARE HOME ADULTS 18-65 198, Powder Mill Lane Whitton Middlesex TW2 6EJ Lead Inspector Simon Smith Key Unannounced Inspection 27th June 2008 1:15 198, Powder Mill Lane DS0000017386.V364722.R01.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 198, Powder Mill Lane DS0000017386.V364722.R01.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. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 198, Powder Mill Lane Address Whitton Middlesex TW2 6EJ 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) 020 8898 7445 020 8898 7445 Powdermilllane@unitedresponse.org.uk www.unitedresponse.org.uk United Response Ms Janice O’Brien Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 20th July 2006 Date of last inspection Brief Description of the Service: 198 Powder Mill Lane is home to five men with learning disabilities. The property is owned and maintained by the London & Quadrant Housing Association. The service is managed by United Response, a not-for-profit provider of community services for people with learning disabilities. The home’s fees are currently £1197.40 per week. The home is situated in a pleasant residential area and benefits from proximity to community resources as well as parks and open spaces. A good standard of decoration has been achieved throughout the home and the property has a well maintained garden. 198, Powder Mill Lane DS0000017386.V364722.R01.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 2 stars. This means the people who use this service experience good quality outcomes. We used evidence from a number of sources to make this judgement about the home. These included visiting the home unannounced and meeting residents and staff. We also looked at some written records, including residents’ care plans. The home met 29 of 32 National Minimum Standards assessed at this inspection. Two standards were almost met and one standard was exceeded. There were two staff on duty at the time of inspection and four residents at home. One resident attended a resource centre in the morning and three residents went to the resource centre in the afternoon, two for outings and one for a one-to-one session. One resident was supported by a member of staff to attend a medical appointment. What the service does well: What has improved since the last inspection? 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 6 Residents’ Health Action Plans have been updated. The garden has been improved by the addition of more plants, furniture and equipment. Some of the fixtures and fittings have also been replaced since the last visit and some parts of the home have been redecorated. The home has a new vehicle, which is larger than the previous one and can accommodate wheelchairs. 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. 198, Powder Mill Lane DS0000017386.V364722.R01.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 198, Powder Mill Lane DS0000017386.V364722.R01.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): Standards 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is clear information about the home and the service it provides. Residents’ needs and strengths are effectively identified. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide, which include information about the service and how to make a complaint. There were five men living at the home at the time of inspection, all of whom have done so for some time. Residents’ needs are assessed at the time of admission. The inspection provided evidence that residents’ needs are regularly reviewed and that the home responds appropriately to any changes in need. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are person-centred and regularly reviewed. The home provides guidance for staff delivering care but some of this information needs updating. Residents receive good support to make informed choices about their lives. The home supports residents in taking manageable risks. The home keeps and shares information about residents appropriately. EVIDENCE: Each resident has an individual care plan. These contained good, individualised information about residents’ strengths, needs, goals and support networks. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 10 Care plans also contained evidence that residents’ health care needs are appropriately recorded and monitored. Some care plans contained ‘personal care guidelines’ that needed updating. There is a commitment to supporting residents to make choices about their lives and to implementing person-centred planning. Residents’ are able to choose the way in which they spend their time at the home and have individual programmes that reflect their interests and preferences. The service consults significant others, such as family members and care managers, where appropriate about residents’ care. The home carries out appropriate risk assessments to enable residents to take risks as part of an independent lifestyle. United Response has issued guidance for staff around risk assessment and management. The guidance aims to balance managing risks with maintaining residents’ rights to live their lives as they choose. The home’s managers were updating residents’ risk assessments at the time of inspection. United Response has a confidentiality statement, which is displayed in the home. This confirms that the organisation complies with the Data Protection Act and states that information about residents will be shared on a ‘need to know’ basis. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 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. Residents’ have individual programmes that reflect their needs and interests. Residents are involved in their local community. Residents receive good support to maintain relationships with their friends and families. Residents’ rights and responsibilities are promoted in their daily lives. The home provides a varied and well-balanced diet. EVIDENCE: 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 12 Residents’ timetables demonstrate that they have good opportunities to participate in activities that reflect their needs and interests, such as bowling, swimming, cycling and music. Residents are active in their local community, making use of shops, pubs, parks and other community resources. Residents also access services provided by a local resource centre. These services include community access and oneto-one work. Most residents have regular contact with their families, which is supported by staff. The home keeps relatives informed about important events affecting residents and invites their input to care reviews. The menu indicated that the home provides a varied and well-balanced diet. Staff said that they aim to support residents in making informed choices about their diet and to promote healthy eating. Residents’ rights and responsibilities are promoted in their daily lives. Interaction between staff and residents was positive during the inspection and staff addressed residents with respect. Residents are able to choose how they spend their time at the home and to have privacy when they want it. Some residents have specific needs around eating and drinking. There was evidence that the home had sought the advice of a speech and language therapist in meeting these needs. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Residents receive excellent care. Residents have access to appropriate health care and treatment when they need it. The home works well with other professionals in delivering care. Changes in need are identified and receive a positive response. Medication is stored and administered administration records were incomplete. EVIDENCE: All residents are registered with a local general practitioner and the home has access to the local community learning disability team, which provides services 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 14 safely but some medication including social work, physiotherapy, occupational therapy, psychiatry and psychology. The inspection provided evidence that the home liaises well with healthcare professionals about residents’ care where necessary. There was also evidence that residents with ongoing conditions such as epilepsy have access to specialist care and regular monitoring. Each resident has a Health Action Plan, which has been updated since the last inspection. The home responds well when residents’ needs change. One resident’s mobility has shown signs of deterioration in recent years. Following an assessment from an occupational therapist, the home made sure that he has access to appropriate equipment to assist his mobility in and out of the home. There is an appropriate system for storing medication and there are written procedures governing its administration. Staff who administer medication attend training before they are authorised to do so. The home has an arrangement with the supplying pharmacist for advice and two annual checks, although the last check on file was dated June 2007. Some of the ‘medication guidelines’ on file were dated March 2006 and needed review. Medication administration records for all residents were checked. These contained no omissions or errors. However the allergy section was not completed on all medication administration records. See Requirement 1. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place for the management of complaints. Staff attend training in the recognition, prevention and reporting of abuse. EVIDENCE: United Response has an appropriate complaints policy, which is available at the home. There is also a Whistle-blowing procedure, which enables staff to report any concerns about they have about poor practice. A record of complaints is kept. There have been no complaints about the home since June 2004. The home works within the ‘Joint Policy on Suspected Abuse of Vulnerable Adults’, which provides guidance for staff in the recognition and reporting of abuse. Staff on duty said that they had attended training in the Protection of Vulnerable Adults. The home keeps records of residents’ expenditure. Two residents’ cash books and balances were checked and found to be accurate, with receipts of expenditure kept. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, safe and well maintained. The communal areas of the home are well decorated and homely. Residents’ bedrooms reflect individual preferences. Residents have access to specialist equipment when they need it. The home is clean and hygienic. EVIDENCE: Powder Mill Lane is a purpose built home in a pleasant residential area with good access to local community facilities, open spaces and public transport 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 17 networks. The home has been well decorated and was very clean and tidy at the time of inspection. There is a large rear garden, which has been improved since the last inspection by the addition of more plants, furniture and equipment. Some of the fixtures and fittings have also been replaced since the last visit and some parts of the home have been redecorated. The communal rooms include a large lounge/dining area and kitchen on the ground floor. Each resident has a single room with basin. Bedrooms are personalised and reflect individual tastes. There are toilet and bathroom facilities on both floors of the home. A ground floor bathroom was being converted to a wet room at the time of inspection. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a stable staff team. Staff know residents’ needs well. Staff are appointed following an appropriate recruitment and selection procedure. Staff have access to appropriate training and good support to do their jobs. EVIDENCE: Each shift has a designated leader and a clear shift plan, which identifies who is responsible for providing personal care and supporting residents with any appointments they have. There was evidence that staff communicate well through regular team meetings, handovers and a communication book. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 19 There is a stable staff team, most of whom have worked at the home for some time. This means that residents’ care is provided by people who know them well. The home has a number of bank staff to cover any vacant shifts. Staff records were not available for inspection in the managers’ absence. The last inspection found that the home carries out appropriate pre-employment checks on staff and staff on duty said they had to provide Criminal Records Bureau Disclosures and references before starting work. Staff said that they get regular individual supervision and good support to do their jobs, including access to regular training opportunities. One member of staff said that the home’s managers are “very supportive”. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a stable and experienced management team. There is a commitment to running the home in residents’ best interests. Records are well organised and maintained. Health and safety checks were comprehensive and up-to-date. Some Requirements relating to food hygiene were outstanding. EVIDENCE: 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 21 There is a stable and experienced management team. This comprises two managers who job share and a deputy service manager. As highlighted in the previous section, this means that staff get good support to do their jobs. The strong management team also means that systems of communication are good and that records in the home are well organised. There is a commitment to running the home in residents’ best interests and to identify ways in which it can improve in meeting their needs. Residents are encouraged to involve themselves in the routines of the home and are consulted about decisions in the home that affect them. The home has an appropriate fire detection system, which is checked weekly by staff using different call points. The fire alarm system was serviced in December 2007 and the fire fighting equipment was checked in September 2007. There was evidence that fire drills are held regularly. Records in the home are well organised and maintained. The Landlord’s Gas Safety Record was issued in March 2008. Portable appliances were tested in January 2008. An electrical installation report was carried out in March 2008. The service has valid Employers Liability Insurance until March 2009. All potentially hazardous substances (COSHH products) were stored safely at the time of inspection and COSHH data safety sheets were available on file. Staff check fridge, freezer and hot water temperatures regularly. The Environmental Health Officer carried out a food hygiene inspection at the home in April 2008. The subsequent report identified seven Requirements relating to the Food Hygiene Requirements (2006). Some of these had been actioned by the time of this visit but others remained outstanding, including the replacement of some seals and worktops in the kitchen. See Requirement 2. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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 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 X 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 2 X 3 X 3 X 3 2 X 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 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. 1 Standard YA20 Regulation 13(2) Timescale for action The Registered Person must 30/08/08 ensure that the allergy section is completed on all Medication administration records. The Registered Person must ensure that all Requirements made by the Environmental Health Officer in relation to the Food Hygiene Requirements (2006) are met. 30/08/08 Requirement 2 YA42 23(5) 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 2 3 Refer to Standard YA6 YA20 YA20 Good Practice Recommendations Update personal care guidelines where necessary. Arrange for the pharmacist to carry out two checks of medication each year. Review residents’ medication guidelines where necessary. 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 24 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 198, Powder Mill Lane DS0000017386.V364722.R01.S.doc Version 5.2 Page 25 - 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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