Care Home: 36 Harvey Road

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What the care home does well People are happy living at the home. Staff are well trained and supported. People`s needs and wishes are well recorded. There are good systems for the day to day running of the home. What has improved since the last inspection? A new person has moved to the home and settled in well. People have tried new activities. What the care home could do better: More permanent staff need to be employed. CARE HOME ADULTS 18-65 Harvey Road Whitton Middlesex TW4 5LU Lead Inspector Sandy Patrick Key Unannounced Inspection 11 September 2008 12:00 th Harvey Road DS0000017371.V371326.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 Harvey Road DS0000017371.V371326.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. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harvey Road Address Whitton Middlesex TW4 5LU 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 8893 3480 harvey.rd@owl-housing.org Owl Housing Ltd Ms D Brenner Ms Maria Diana Inniss Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Harvey Road DS0000017371.V371326.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: Either 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 28th July 2006 Date of last inspection Brief Description of the Service: 36 Harvey Road is a care home for up to five adults with learning disabilities, all of whom may be over 65 years of age. The property is owned and maintained by Richmond-upon-Thames Churches Housing Association and the service is operated by Owl Housing. The home is situated in a pleasant residential area with access to local shops, cafes, pubs as well as parks. There is an adequate sized garden to the front and rear of the property. Harvey Road DS0000017371.V371326.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 visited the home on the 11th September 2008. The visit was unannounced. We met with the people who live at the home, the Manager and staff on duty. We looked at records, the environment and saw how people were supported. We wrote to the Manager and asked her to complete a quality self assessment about the home. We wrote to people who live at the home, their visitors and staff and asked them to complete surveys about the home. 1 person living at the home, 5 staff and 3 professionals completed surveys for us. We looked at all the information we had received about the home since the last key inspection. Some of the things people said about the home were: ‘They care, listen and support the needs of people living at the home and the workers.’ ‘There is a person centred approach to care.’ ‘There are different activities and day trips’. What the service does well: What has improved since the last inspection? What they could do better: More permanent staff need to be employed. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 6 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. Harvey Road DS0000017371.V371326.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 Harvey Road DS0000017371.V371326.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): 1, 2, 3, 4 & 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are given information about the home, are able to visit and have their needs assessed before they move there. EVIDENCE: The person who lives at the home and who completed a survey for us said that there was enough information to help them when they moved there. There are clear guides to the home including a pictorial guide for people living there. These were reviewed and updated earlier in the year and include the terms and conditions of residency. One person has moved to the home since we last inspected. The Manager and placing authority assessed their needs. The Manager told us that she had visited the person and that the person had visited Harvey Road a number of times before the move, including over night stays. We saw evidence of assessments and of consultation with the person’s previous home and other significant people. Harvey Road DS0000017371.V371326.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): 6, 7 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’s needs are wishes are recorded and staff are able to meet these. EVIDENCE: People who sent us surveys and who spoke to us at the inspection said that individual needs are met. We saw that staff used the care plans during their work and considered each person’s needs and how they could meet these. There is a care plan for each person and guidelines telling staff about the support they need. These are clear, and written in a way which respects individuality and dignity. Care plans referred to people’s wishes and likes and things that are important to them. Where people cannot express their wishes, the staff had gathered information from relatives and other important people in their lives. Most records were dated and signed but some were not and need to be. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 10 We saw evidence that risks were assessed and that people were supported to take risks. Some people have advocates who visit them regularly. Some people cannot communicate their needs or make choices. We saw that the staff worked with other professionals, advocates and families, made observations and worked together to give people the support they needed and to help them to express themselves and make choices wherever possible. Harvey Road DS0000017371.V371326.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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported to take part in a range of different activities and to use the community. EVIDENCE: People who contacted us said that they felt the people living at the home were able to take part in a range of different activities which reflected their choices and needs. We saw people relaxing at home and supported with meals. We saw the staff supporting people to play card games and chatting and spending time with them. The atmosphere was relaxed and people were happy and having their needs met. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 12 People from the home use a local resource centre and visit swimming pools and sensory centres. They use the local community, shops and facilities and we saw evidence of this. An aromatherapsit visits the home weekly. We saw photographs of people enjoying different activities. People are supported to maintain friendships and contact with their families. We saw evidence of this. Some people have gone on holiday this year, but the lack of permanent staff had meant that some people could not go on holiday. There is a selection of nutritious and fresh food at the home and the menu is varied. We saw people being supported at meal times. People’s likes and dislikes are clearly recorded. Harvey Road DS0000017371.V371326.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): 18, 19 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have their health, personal and medication needs met. EVIDENCE: People living at the home have a lot of different health and personal care needs. The staff work closely with other professionals to make sure people’s needs are met. We saw evidence of consultation with professionals and guidelines they have written which the staff follow. Professionals offer regular training and support. One professional told us, ‘the staff support people to meet their complex health needs’. One professional thought, ‘The staff appear to be quite nursing focused and they could be better at respecting people’s privacy and dignity’. They told us they wanted people living at the home to be better empowered. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 14 Staff are trained in administering medication and assessed by the Manager. There is an appropriate medication procedure and guidelines. We saw that medication was stored appropriately and that records were well kept and accurate. There are regular audits of medication and the pharmacist visits and inspects the medication storage and records twice a year. Harvey Road DS0000017371.V371326.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): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are appropriate procedures to keep people safe and to support them to make complaints. EVIDENCE: The people completing surveys about the home said that they knew what to do if they had a complaint. There is a complaints procedure and this is available in pictorial format. There is a record for complaints. There have been no complaints since we last inspected the home. There is a suggestion box in the hallway. The organisation has a procedure on abuse and there is a copy of the local authority protection of vulnerable adults procedure at the home. The staff have all had training in this area. The staff we spoke to had a good understanding of this. Staff support people to manage their money. Small amounts of cash are held at the home. We saw records of these were accurate and systems for managing and recording expenditure were good. However, records and balances were not checked daily and this could lead to potential inaccuracies. We discussed this with the Manager who said that she would think about how money could be more safely managed. Harvey Road DS0000017371.V371326.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): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a safe and well maintained environment. EVIDENCE: There have been improvements to the building since we last visited. These include some decoration, new flooring in some rooms and improvements to the garden. The home is attractively decorated and well maintained. There is a fish tank, some sensory equipment and pictures in communal areas. Bedrooms have been personalised. We felt people may benefit from more sensory equipment. The garden is well maintained and has areas of seating. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,\32, 33, 34, 35 & 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported by well trained staff but the lack of a permanent staff team has a negative impact on the service they receive. EVIDENCE: There is a high turn over of staff at the home and this causes problems for continuity and general management. People living at the home do not have the same consistent and familiar staff. A lot of tasks are undertaken by the Manager and if there was a permanent staff team these could be shared by all staff. People are not always able to go on holidays or do different activities because of a lack of staff. People do not have a regular keyworker. The Manager tries to counteract some of these problems by organising the same agency and temporary staff but the employment of a permanent staff team is needed. There are a high number of staff vacancies. A new member of staff had started working at the home shortly before the inspection and we saw the manager supporting her with her induction. The Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 18 Manager told us that she was recruiting some other staff and was interviewing candidates the week after our visit. There is an allocated staff member to organise each shift and there are good systems for communicating information to all staff, including regular meetings and a handover of information each time the staff change. The staff who completed surveys and those who spoke to us said that they had good support and training. They said that they had regular team meetings and had enough information to help them with their jobs. One member of staff said, ‘I have monthly supervisions and daily handovers and have lots of information to help me in my job.’ Another staff told us, ‘we have good training which is targeted to meet the different needs of people who use the service’. And another member of staff said, ‘the inductions are very good and so is the training’. The organisation provides a range of training for staff and they also access local authority training. There is an induction booklet for new staff and they are supported to undertake NVQ training once they have completed this. The Manager told us that she makes sure the staff from agencies are trained in the key areas. We looked at training records for staff and saw that they had undertaken a range of training including, moving and handling, food hygiene, fire safety medication, protection of vulnerable adults and first aid. There are regular training up dates for people. Checks including reference checks and criminal record checks are made on staff before they start work at the home. The Manager interviews all staff with the Deputy Manager. People living at the home meet potential staff during the interview. We saw evidence of regular team and individual supervision meetings. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 19 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 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a well managed home. EVIDENCE: The Manager demonstrated a good knowledge and understanding of the people who live at the home. She is appropriately experienced and is qualified to NVQ Level 4. The Manager told us that the organisation offers her a lot of support and she has regular supervision with her line manager. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 20 Representatives of the organisation visit the home and check the quality of the service each month. They write a report of their findings and send this to us. The Manager has sent relatives questionnaires about the service. The Manager told us that the fire officer had inspected the home the day before our visit. He had been generally happy with the fire safety precautions and had made one recommendation where a fire door was not closing properly. We saw that there were regular recorded checks on health and safety and fire safety. We saw that action was taken where things were wrong. We saw evidence that electrical wiring, appliances and gas were checked by appropriate professionals. Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 21 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 3 4 3 5 3 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 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 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 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 Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 22 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 YA33 Regulation 18 Requirement Timescale for action The Registered Person must 30/11/08 make sure that the lack of permanent staff does not have a negative impact on the service. 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 YA7 Good Practice Recommendations The Manager should make sure all records are dated and signed. The Registered Person must make sure money held on behalf of people is checked regularly and that systems are robust and protect them from potential abuse. The Manager should make sure anyone who wants is supported to go on holiday, if this is their choice. 2 YA23 3 YA14 Harvey Road DS0000017371.V371326.R01.S.doc Version 5.2 Page 23 4 YA24 The Manager should consider equipping the house with more sensory equipment for people to use each day. The Manager should make sure the recommendations of the fire officer are met. 5 YA42 Harvey Road DS0000017371.V371326.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. 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