Care Home: 48 The Grove

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What the care home does well Different cultural and/or religious needs are being at the home and is reflected in a diverse staff group. The care needs and aspirations of prospective residents are comprehensively assessed by representatives of the service prior to admission. Care plans and behavioural support plans are being drawn up and regularly reviewed. Associated risk assessments are also undertaken. Residents are able to make decisions regarding their daily living routines, they receive opportunties for personal development and are supported in shared and/or individual activity within the community on a daily basis. Varied and nutritional meals are provided and includes specific cultural/options which are prepared separately. The safety and welfare of residents are being protected. Their physical and emotional health care needs of residents are being fully met and include weekly therapies. Residents were appropriately dressed. They appeared calm and well adjusted and moved freely around the premises. Those spoken with reported being happy at the home. Support workers expressed satisfaction with the training and support they received for meeting the needs of residents. They were competent and attentive and interacted with residents in a friendly manner. Overall, the home was clean, hygienic and well maintained. The environment was open, inclusive and homely. What has improved since the last inspection? Residents appeared settled and calm and there have been no recent mental health relapses. What the care home could do better: Two requirements were identified at this inspection. Specifically, the service must submit Regulation 37 forms to the CSCI as required and copies of all recruitment documents in relation to all care staff must be held at the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 48 The Grove The Grove Isleworth Middlesex TW7 4JF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jean Bovell     Date: 0 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 48 The Grove The Grove Isleworth Middlesex TW7 4JF 02087589158 Telephone number: Fax number: Email address: Provider web address: ganstead@gcpcare.com Name of registered provider(s): Type of registration: Number of places registered: Grove Care Partnership Ltd care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 48 The Grove is a large detached three-storey house which is located in a residential area of Isleworth. There are nine bedrooms with en-suite shower/toilet facilities on the upper floors and there is a passenger lift. Two separate toilets, a lounge, an activities room, a dining room and other spaces including a smoking room are situated on the lower floors. The garden/patio and parking areas are enclosed. The home is within walking distance to Isleworth main line station and there are nearby bus links to Hounslow town centre, Brentford, Richmond, Kingston and Hounslow East underground station. The Care Home is owned by Grove Partnership and was registered in September 2004 for nine adults with learning disabilities and associated physical disabilities and sensory impairment. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 9 Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out between 3:45 pm and 7:00 pm on 6th November 2008. During the course of the inspection records, documents, policies and procedures in relation to key Standards were viewed. Observations were made and a tour of the building was undertaken. The Registered Manager, one Team Leader and three care support workers were spoken with. A completed annual quality assurance assessment document (AQAA) was considered. Care Homes for Adults (18-65 years) Page 6 of 29 All key Standards were examined. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Adults (18-65 years) Page 8 of 29 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care needs of prospective residents are assessed comprehensively prior to admission. Evidence: The personal files of four residents were viewed at random and contained documented evidenced that comprehensive needs led assessments were being carried out by the home prior to the admission of prospective residents. It was indicated also, that relatives, previous carers, day centres, social workers and health care professionals participated in the process of ensuring that the service was equipped to meet separate identified needs and aspirations. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The changing needs of residents are reflected in separate care plans and related risk assessments are undertaken. Residents are able to make decisions regarding their daily living routines. Evidence: It was reflected on four care plans that were inspected at random that the changing personal, dietary and social needs of residents were being assessed and that action plans and set goals were put into place. Behavioural support plans which detailed triggers and strategies for identifying and supporting residents during specific presented challenges were also in place. Risk assessments in relation to activities and behavioural triggers within care and behavioural support plans had been undertaken. These included hitting, spitting and Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: throwing, personal care and college. Care plans, behavioural support plans and risk assessments were regularly reviewed. We were informed by a support worker that residents were able to make decisions regarding their daily living routines such as activities, meals, times of getting up on mornings/retiring at night, what they wore each day and personal purchases. People were observed moving freely around the home and their individuality was reflected in the way they were dressed, accessories, hairstyles and personalised bedrooms. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive opportunities for meeting their aspirations, their cultural and religious needs are being met and they are supported in participating in shared and/or separate activities in the community. Contact with relatives is encouraged and facilitated. People with capacity undertake appropriate housekeeping tasks. Varied and nutritional meals including religious/cultural options are being provided to residents. Care Homes for Adults (18-65 years) Page 14 of 29 Judgement: Residents receive opportunties for personal development and their religious needs are being met. Residents are supported in paticipating in shared and/or separate activities in the community and are able to maintain contact with relatives. People with capacity undertake appropriate housekeeping tasks. Varied and nutritious meals including cultural options are being provided. Evidence: Individual aspirations, religious and cultural needs and social interests were identified within care plans that were viewed at random. Separate activities programmes were on display in the office. The home owns a vehicle for transporting residents to and from shared actviities within the community. It was indicated on records viewed that people attended Church services on a Sunday. They were enrolled onto college courses such as drama, cooking and life skills, were in part-time employment and visited day centres. Residents were supported by care staff while participating in a variety of shared and/or separate activity in the community on a daily basis. These included swimming, horseriding, shopping and meals out. Annual holidays are also arranged. An individual spoken with confirmed that he/she attended college and also had a parttime job. Residents accompanied by support staff were observed returning from various shared and/or separate outdoor activities at the time of the inspection. One person was escorted to part-time employment. We were informed by a Team Leader that residents maintained telephone and/or visiting contact with relatives. Residents also visited relatives at home and were taken out by them. A resident spoken with, said: I see my mum alot. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Support workers reported that residents with capacity carried out housekeeping tasks such as laundry, tidying bedrooms and clearing the dining table. Stocks of fresh, dried and frozen foods, juices and snacks were stored appropriately in the kitchen. Fresh fruit was accessible. Separate storing space, untensils and cooking equipment were in place for storing and preparing foods for meeting the needs of residents with different cultural/religious needs. Menus were reflective of wholesome and varied cooked meals including religious/cultural requirements being provided. Support workers spoken with confirmed that snacks and drinks were readily available. Appealing and nutritious supper options were observed being offered to residents at the time of the inspection. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal, emotional and healthcare needs of residents are being fully met and policies and procedures on medication are comprehensive. Evidence: The personal needs of residents were identified within support plans and indicated that they required assistance, supervision or prompting with personal care routines. However, they maintained independence regarding choice of clothing/accessories, make-up and hairstyles. The healthcare needs of residents were incorporated within annual OK health checks. Records were reflective of people receiving access to health care professionals when required and being accompanied to medical appointments. Art, music and aroma therapies were provided to residents on a weekly basis. People who use the service appeared healthy, comfortable and calm. A Team Leader reported that there had been no recent relapses in relation to residents with underlying mental health difficulties. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Policies and procedures on medication were in place and comprehensive. Prescribed medicines were safely and appropriately stored and medication adminstration sheets were accurately documented and signed. Records were maintained of medication received and returned to the Pharmacist. Training records were reflective of Boots accredited medication training being delivered to care support staff. A team leader confirmed that residents lacked capacity to self-administer medication. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is appropriately detailed and people are being protected from abuse. Regulation 37 forms are not being completed and submitted to the CSCI where appropriate. Evidence: The complaints procedure was clearly detailed and written and illustrated in a format suitable for meeting the needs of people who use the service. The complaints book was viewed and indicated that no complaints had been received at the home following the last inspection. Although incidents and accidents were being recorded onto incident and accident forms, information was not clearly detailed nor was preventive action inluded on each form. It was also noted that Regulation 37 forms were not completed and submitted to the CSCI as required. These issues were discussed with the Registered Manager and we were assured that appropriate action would be taken. We were informed by the Registered Manager that residents received state benefits and payments were deposited into separate bank accounts. The Registered Manager Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: was granted appointee to three residents. One person handled his/her own money and relatives or placing authorities held responsibility for the financial affairs of others. Cash allowances were secured at the home. Separate financial records which detailed expenditure in relation to cash allowances were inspected at random and no discrepancies were identified. Records were indicative of staff training on the Protection of Vulnerable Adults being delivered. Refresher training on Safeguarding Adults was scheduled for December 2008. Policies and procedures on the Protection of Vulnerable Adults were in place. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being well maintained. Residents bedrooms are suitably furnished, fitted and personalised. The environment is pleasant and homely. Evidence: The communal areas of the home are spacious and suitable for shared and/or separate activity. All furnishings and equipment were appropriate for purpose and of good quality. No issues were identified in relation to the laundry. The garden was being maintained and accessible to residents. Residents occupied single bedrooms that were suitably furnished and fitted and contained en-suite bathroom facilities. All bedrooms were reflective of separate choices and interests. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Overall, the home was well maintained, clean and hygienic. The environment was homely and safe. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Support workers are qualified and receive appropriate trainining and refreshers for meeting the needs of people who use the service. Copies of all required documents are not within all staff recruitment files held at the home. Evidence: It was indicated on staff rotas that five support workers were on duty during waking hours. There was one waking and one sleeping staff cover at night. We were informed by the Registered Manager that of sixteen care staff employed at the home nine had achieved NVQ level 2 or above. Individual training records were in place. It was reflected that care staff received induction training and that subsequent training and refreshers appropriate for meeting the needs of residents were being delivered. Support workers were observed being competent and attentive. Those spoken with expressed satisfaction with the support they received and training delivered for Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: meeting the needs of residents. Six staff recruitment files were inspected at random but all required recruitment documents were not within all files viewed. This issue was discussed with the Registered Manager. We were informed that orginal recruitment documents were held at Head Office and that a request will be made to have copies of all missing documents sent to the home. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Manager is suitably qualified and experienced. Annual quality assurance has been satisfactorily undertaken. The health, safety and welfare of residents are being protected. Evidence: The Registered Manager has been in post for 18 months. He has had six years managerial experience and holds the Registered Managers Award and NVQ level 4. A Team Leader and support workers spoken with reported that the Registered Manager was always trying to make things better introduced new changes was a good listener supportive and approachable. An annual quality assurance assessment (AQAA) was satisfactorily completed and returned to the CSCI. The document included details of what the home did well and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: areas which could be improved. Numerical information was also provided. Health and safety records were up-to-date and included portable appliances tests, gas maintenance, water temperature and fire safety checks. Fire drills were being regularly undertaken and environmental risk assessments had been carried out. The records indicated that staff training and refreshers were being delivered on Health and Safety, Moving and Handling, Food Hygiene, First Aid and Fire Safety. Policies and procedures on Health and Safety were in place and appropriately detailed. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 37 The Registered Person must make sure that where appropriate Regulation 37 forms are completed and faxed to the CSCI. To ensure that the safety and welfare of residents are being protected. 15/12/2008 2 34 19 The Registered Person must 30/12/2008 make sure that copies of all the information required under schedule 2 of the care homes regulations 2001 are within all recruitment files held at the home. To ensure that these documents are accessible for viewing by CSCI inspectors. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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