Care Home: 45a, Hampton Road

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What the care home does well Gives residents excellent support to make important decisions about their lives. Provides personal centred care and supports residents in achieving their goals. Reviews residents` needs regularly to ensure the home can meet their needs. Works well with other professionals in delivering care where necessary. Promotes residents` participation in their community. Provides opportunities for residents to access a range of social and leisure activities. Supports residents to develop and maintain positive relationships with their friends and families. Provides a stable and committed staff team. Provides a skilled and experienced manager. Facilitates good communication amongst staff. Encourages staff to contribute to the development of the service Office systems and records are very well organised. What has improved since the last inspection? Residents have been supported to develop new skills and do more for themselves. The garden has been improved. Some staff have completed National Vocational Qualifications. A volunteer has been recruited to work with residents on a regular basis. The new shift plan format provides more information. CARE HOME ADULTS 18-65 45a, Hampton Road Teddington Middlesex TW11 0LA Lead Inspector Simon Smith Key Unannounced Inspection 17th July 2008 1:15 45a, Hampton Road DS0000017368.V364719.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 45a, Hampton Road DS0000017368.V364719.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. 45a, Hampton Road DS0000017368.V364719.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 45a, Hampton Road Address Teddington Middlesex TW11 0LA 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 8977 5406 020 8977 5406 hampton.road@unitedresponse.org.uk www.unitedresponse.org.uk United Response Mrs Jacqueline Mary McKinney Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 45a, Hampton Road DS0000017368.V364719.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 22nd August 2006 Date of last inspection Brief Description of the Service: The home was opened in 1996 and is registered with the CSCI to accommodate a maximum of five adults with learning disabilities, two of whom may have physical disabilities. The property is owned and maintained by Metropolitan Support Trust. The service is managed by United Response, a not-for-profit provider of community services for people with learning disabilities. The home benefits from proximity to public transport networks and good shopping and community facilities. A high standard of decoration has been achieved throughout and the property has a well-maintained garden. 45a, Hampton Road DS0000017368.V364719.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 3 stars. This means the people who use this service experience excellent quality outcomes. We used evidence from several sources to make this judgement about the home. The inspector visited the home unannounced and met all five residents and spoke to three staff on duty. The inspector also met a relative who visits every week and spoke to the manager by telephone. We also looked at some written records, including residents’ care plans. The home met 25 of 32 National Minimum Standards assessed at this inspection. Seven standards were exceeded. What the service does well: What has improved since the last inspection? 45a, Hampton Road DS0000017368.V364719.R01.S.doc Version 5.2 Page 6 Residents have been supported to develop new skills and do more for themselves. The garden has been improved. Some staff have completed National Vocational Qualifications. A volunteer has been recruited to work with residents on a regular basis. The new shift plan format provides more information. 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. 45a, Hampton Road DS0000017368.V364719.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 45a, Hampton Road DS0000017368.V364719.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 2 and 3 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 are regularly reviewed to ensure the home can meet their needs. 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 people living at the home at the time of inspection, four of whom have lived there since it opened in 1996. Residents’ needs are assessed at the time of admission and care plans are reviewed regularly to make sure that the service still meets their needs. 45a, Hampton Road DS0000017368.V364719.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 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans are person-centred and regularly reviewed. Residents get excellent support to make decisions about their lives. The home supports residents in taking manageable risks. EVIDENCE: The inspector looked at some residents’ care plans. These contained excellent, individualised information about residents’ strengths and needs. The home is committed to person centred planning and there was lots of good information about residents’ communication needs. All the information on residents’ care plans was up to date and regularly reviewed. The manager said that residents’ individual plans are reviewed at 45a, Hampton Road DS0000017368.V364719.R01.S.doc Version 5.2 Page 10 regular ‘circle of support’ meetings, to which people such as relatives, relevant professionals and resource centre staff are invited. The home is committed to enabling residents to take control of their lives and there are some good examples of how this has been achieved. The residents’ placing authority plans to introduce a system of self directed support, which enables service users to choose and purchase their care. The manager has been in contact with the placing authority to ensure that residents will be able to take up this opportunity when it arises. Some residents have had the support of an independent mental capacity advocate to help them make important decisions. The home carries out risk assessments to enable residents to take risks as part of an independent lifestyle. There is a written risk assessment protocol, which aims to “balance risks with rights and responsibilities”. United Response issued new guidance about risk assessments in 2007, which was designed to make them more person centred. 45a, Hampton Road DS0000017368.V364719.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 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to develop skills and to do things for themselves. Residents’ have individual programmes that reflect their needs and interests. Residents have active social lives and 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’s menu is varied and designed to meet residents’ needs. EVIDENCE: 45a, Hampton Road DS0000017368.V364719.R01.S.doc Version 5.2 Page 12 Staff said that residents now do more for themselves than before and that this has increased their independence. For example residents are now more involved in day to day tasks such as laundry, mealtimes, recycling, and collecting their medication. All residents attend weekly sessions based in the community. The home has established links with other residential services in the area and works with them in providing a range of day opportunities for residents. Residents are involved in their local community, making use of shops, pubs, banks and other resources, and receive good support to maintain relationships with their friends and families. There was evidence that residents have active social lives, visiting theatres, parks, sports events and social clubs. All residents take an annual holiday. 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. 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. There was evidence that the home had sought the input of professionals including a dietician where residents have specific needs around eating. 45a, Hampton Road DS0000017368.V364719.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 personal support in the way they prefer. Residents have access to appropriate health care and treatment when they need it. The home works well with other professionals in making sure residents receive good care. Medication is stored and administered safely. EVIDENCE: Staff on duty had a good knowledge of residents needs. There is good guidance for staff in their work to make sure that residents receive consistent care in the way they prefer. 45a, Hampton Road DS0000017368.V364719.R01.S.doc Version 5.2 Page 14 There was evidence that the home seeks the advice of appropriate healthcare professionals where necessary about residents’ care. 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 and well being file, which contained detailed information on all aspects of residents’ health and well being. Medication was stored appropriately and there are clear, written procedures governing the administration of medication. Staff who administer medication attend training before they are authorised to do so. All medication coming into or leaving the home is recorded. Medication records were checked and found to be accurate. 45a, Hampton Road DS0000017368.V364719.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 the last inspection. 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. The home’s training matrix showed that some staff need to attend refresher training in the Protection of Vulnerable Adults. The manager said that these staff have applied to attend this training and have been allocated places in October 2008. 45a, Hampton Road DS0000017368.V364719.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, 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 rooms of the home are welcoming and homely. Residents’ bedrooms reflect individual preferences. Residents have access to specialist equipment when they need it. The home is clean and hygienic. EVIDENCE: The home is situated between Teddington and Hampton Hill, close to shops, community facilities and open spaces. A good standard of decoration has been achieved throughout the building. 45a, Hampton Road DS0000017368.V364719.R01.S.doc Version 5.2 Page 17 The communal rooms include a kitchen and a large lounge/dining area, which has access to the garden. Much effort has been put into improving the garden since the last inspection, including fundraising events to buy plants. There were some very homely touches, such as fresh flowers and photographs of residents. Each resident has a single ground floor bedroom with washbasin. Individual rooms are personalised and reflect individual tastes. There was evidence that residents have access to specialist equipment when they need it and that this is serviced regularly. All parts of the home were clean and hygienic. 45a, Hampton Road DS0000017368.V364719.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. Staff communicate well with one another. 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: There are good systems of communication amongst staff, such as regular team meetings and handovers and an effective communication book. Each shift has a nominated leader. There is a detailed shift plan, the format of which has been improved since the last inspection. This identifies who is responsible for 45a, Hampton Road DS0000017368.V364719.R01.S.doc Version 5.2 Page 19 providing personal care and supporting residents with any appointments they have. Staff have access to on call support from managers if required. There is a stable staff team, most of whom have worked at the home for some time. Two members of staff left since the last inspection but staff on duty said that these posts have been filled. Staff said that the home has access to bank and agency staff if necessary to cover vacant shifts. The manager said that a team of bank staff is being developed, which will eliminate the need to use agency staff in future. 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 have access to good training opportunities. Including mandatory training. The AQAA told us that seven of ten staff have achieved a minimum of NVQ level 2. Two staff on duty said they had completed NVQ level 3 but were awaiting verification. Staff said that they have regular supervision with the home manager and good support from manager to do their jobs well. 45a, Hampton Road DS0000017368.V364719.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, 38, 39, 41 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a skilled and experienced manager. The manager provides good leadership and guidance. Staff are committed to running the home in residents’ best interests. The health and safety of residents and staff is maintained. EVIDENCE: 45a, Hampton Road DS0000017368.V364719.R01.S.doc Version 5.2 Page 21 The manager has much relevant experience and qualifications, including the Registered Managers Award, as well as a real commitment to improving the service residents receive. The manager provides good support to the staff team and encourages their input into the development of the service, for example at team meetings and at the awayday held annually. There is a commitment to running the home in residents’ best interests and to supporting them in achieving their goals. Residents are encouraged to involve themselves in the routines of the home and are consulted about decisions in the home that affect them. Office systems and records are very well organised. The home has Employers Liability Insurance until March 2009. There was evidence that all equipment used by residents is serviced regularly. The manager said that all portable appliances were tested for safety in February 2008 and that a full electrical check was carried out in June 2008. The home has an appropriate fire detection system, which is checked regularly by staff using different call points. Fire drills are held regularly. 45a, Hampton Road DS0000017368.V364719.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 X 2 3 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 X 26 3 27 X 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 4 4 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 3 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 3 X 3 3 X 45a, Hampton Road DS0000017368.V364719.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. 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. Refer to Standard Good Practice Recommendations 45a, Hampton Road DS0000017368.V364719.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 45a, Hampton Road DS0000017368.V364719.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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