Care Home: Bear Road (82)

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What the care home does well The home provides a service to people of different cultural and religious needs. Prospective residents are comprehensively assessed prior to admission. Care plans and risk assessments are satisfactorily undertaken, clearly detailed and regularly reviewed. People receive opportunities for meeting their aspirations and are supported in participating in organised and separate activities within the community. All records, documents, policies and procedures viewed were satisfactory and indicated that the health, safety and welfare of residents were being fully protected. Staff training and refreshers appropriate for meeting the needs of people who use the service, are being regularly delivered. Support workers were observed being competent and attentive in meeting the needs of residents. Residents appeared appropriately dressed, well adjusted and happy. Those spoken with expressed satisfaction with the support they received from care staff and related in a friendly manner with them. Overall, the home was clean, hygienic and very well maintained. The environment was bright, homely and lively. What has improved since the last inspection? No requirements were made at the last inspection. CARE HOME ADULTS 18-65 Bear Road (82) 82 Bear Road Hanworth Middlesex TW13 6RG Lead Inspector Ms Jean Bovell Key Unannounced Inspection 24th July 2008 11:00 Bear Road (82) DS0000069305.V366908.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 Bear Road (82) DS0000069305.V366908.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. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bear Road (82) Address 82 Bear Road Hanworth Middlesex TW13 6RG 020 8614 6995 0208 614 6996 jgardner@gcpcare.com www.gcpcare.com Grove Care Partnership Ltd 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) Josephine Gardner Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Bear Road (82) DS0000069305.V366908.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 - Code 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 8th June 2007 Date of last inspection Brief Description of the Service: 82 Bear Road provides a service to people who have a learning disability. The home is owned by Grove Partnership Ltd and is a five bedroomed house in Hanworth. One single bedroom, adjoining ensuite bathroom and one staff sleep-in room are situated on the upper first floor of the building. There are four single bedrooms with ensuite facilities on the first floor and the ground floor consists of a large kitchen/dining area, office, laundry room and two lounges which are appropriate for shared and/or individual activity. A separate activities room is within an outbuilding at the bottom of the rear garden and patio. There is ample parking space at the front of the building and bus links to local shopping centres and Hounslow East underground station are within short walking distance. There are currently two vacancies at the home and weekly fees range from between £1,500 and £2,200. Bear Road (82) DS0000069305.V366908.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 three stars. This means the people who use this service experience excellent quality outcomes. This inspection was carried out between 11:00 am and 5:00 pm on 24th July 2008. The Manager Designate, three support workers and four residents were at the home. We were informed by the Registered Manager that one resident had been admitted to hospital. During the course of the inspection: records, documents, policies and procedures were viewed. A tour of the building was undertaken and observations were made. We spoke with four residents and four support workers. A completed Annual Quality Assurance Assessment – self assessment document submitted to the CSCI, was considered after the field visit and all key Standards were examined. The Registered Manager and a Senior Support Worker provided appropriate assistance throughout the inspection. What the service does well: The home provides a service to people of different cultural and religious needs. Prospective residents are comprehensively assessed prior to admission. Care plans and risk assessments are satisfactorily undertaken, clearly detailed and regularly reviewed. People receive opportunities for meeting their aspirations and are supported in participating in organised and separate activities within the community. All records, documents, policies and procedures viewed were satisfactory and indicated that the health, safety and welfare of residents were being fully protected. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 6 Staff training and refreshers appropriate for meeting the needs of people who use the service, are being regularly delivered. Support workers were observed being competent and attentive in meeting the needs of residents. Residents appeared appropriately dressed, well adjusted and happy. Those spoken with expressed satisfaction with the support they received from care staff and related in a friendly manner with them. Overall, the home was clean, hygienic and very well maintained. The environment was bright, homely and lively. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bear Road (82) DS0000069305.V366908.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 Bear Road (82) DS0000069305.V366908.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The separate needs and aspirations of prospective residents are comprehensively assessed prior to admission. Written contracts/statement of terms and conditions are being signed as required. EVIDENCE: The personal files of five residents were inspected. It was evidenced in each file that the home had obtained a written assessment including background history from the placing authority at the point of referral. It was indicated, also, that a comprehensive needs led assessment was subsequently undertaken by the Providers. Prospective residents, relatives, social workers and healthcare professionals were involved in the process of determining the capacity of the home to meet separate identified needs and aspirations on which initial care plans were based. Written contracts/statement of terms and conditions relating to five residents were viewed and all were appropriately signed and dated. Bear Road (82) DS0000069305.V366908.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 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 and risk assessments are clearly detailed and regularly reviewed. People are encouraged to be independent regarding their daily living routines and in relation to their environment, where appropriate. EVIDENCE: Care plans relating to five residents were examined. It was reflected that people’s changing personal, healthcare, social, education and employment needs were being assessed and action plans and set goals for meeting identified needs were in place. Risk assessments associated with specific activities identified within care plans were carried out. These included accessing the community, getting off at the Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 10 wrong bus stop, working with sharp gardening tools and verbal/physical aggression. All care plans and risk assessments viewed were clearly detailed, appropriately signed and reviewed on a three monthly basis. We were informed by a Senior Support Worker that people who use the service were taught ‘life skills’ such as ‘budgeting’. Residents received weekly state benefits that were deposited into their separate bank accounts and maintained independence in spending their money. People received choice in relation to meals and accompanied support workers during the weekly shop. They also made decisions regarding their daily living routines such as when they got up on mornings/retired at night and what they wore each day. A Senior Support Worker reported that residents were encouraged to suggest colour schemes for decorating the home and were involved in choosing furniture. An individual confirmed that he/she chose and assisted with fitting cupboards in the home’s kitchen. People were observed moving freely around the home. They were independent in the local community, and individual choice was reflected in personalised bedrooms. Bear Road (82) DS0000069305.V366908.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): 12, 13, 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. The cultural and religious needs of people who use the service are being met. They participate in activities in the community and maintain contact with relatives and/or friends. Residents assist with appropriate housekeeping tasks. Varied and nutritious meal options are being provided. EVIDENCE: The religious, cultural and social needs of people who use the service were identified in their separate care plans. An activities chart was in place and indicated that residents attended Church services and religious/cultural festivals. They were in paid employment, attended college courses in Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 12 computing and literacy, and received opportunities for pursuing particular interests such as dance and/or athletics. Annual holidays were arranged and the home’s vehicle was used for regular day trips. Additional activities in the community included football, swimming and visiting cinemas, pubs and social clubs. Bicycles are provided at the home and we were informed by a Senior Support Workers that residents were accompanied on ‘bike rides’. The home has activities room where people are able to participate in joint or individual activity such as table tennis, darts and art. Residents reported having ‘a job’, a personal ‘dance tutor’ and/or being accompanied by support staff during regular visits to a local Church. Photographs depicting holidays that were taken abroad and organised cultural events were viewed. Residents received support or were independently involved in various separate activities in the community at the time of the inspection including bike rides and shopping. People were observed moving freely and comfortably around the house. But an individual alleged that he/she experienced difficulties when interacting with one or two residents and as a consequence spent a considerable amount of time in his/her bedroom. The Manager Designate confirmed that contact with relatives and/or friends were encouraged and facilitated. Weekend and/or overnight stays with relatives occurred on a regular weekly basis. People were able to develop and maintain personal friendships and/or relationships. A written schedule was on display in the kitchen and indicated that residents were allocated to assist with housekeeping tasks such as cooking and shopping on specific days. A support worker reported that residents tidied their bedrooms and carried out personal laundering. An individual was observed vacuuming communal areas during the inspection. Sufficient stocks of fresh, frozen and dried food were appropriately stored. Varied and nutritional meal options including cultural choices were reflected on menus. A senior support worker confirmed that people received support if they chose to prepare a separate meal. We were informed by the Manager Designate that residents received £10 each week for purchasing their favourite foods which they stored in separate lockable cupboards. These were seen in the home’s kitchen. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 13 Residents were observed moving freely around the kitchen and independently preparing drinks and snacks. Separate requests for specific foods such as fruit and juices were purchased by support workers. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People receive support with personal care as required and their healthcare needs are being met. Procedures in relation to medication are satisfactory. EVIDENCE: The personal care needs of residents were identified within their separate care plans. It was evidenced that they required prompting or reminding with their personal care routines but were able to choose what they wore each day. Residents were observed being appropriately dressed and well presented. The changing healthcare needs of people who use the service were recorded within care plans. It was indicated that they received access to healthcare professionals such as General Practitioners, Psychiatrists, Psychologists, Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 15 Dentists and Dieticians as and when required. Aromatherapy and music/dance therapy were also provided and people were supported during medical appointments. A resident was accompanied to a GP appointment at the time of the inspection. The home’s policy and procedures on medication were in place. Medicines were appropriately stored. Medication administration sheets were accurately documented and signed and included information regarding those who refused to take prescribed medication. Records of medicines received and returned to the Pharmacist were being maintained. Controlled medication was separately and securely stored and accurately documented. The signatures of two support workers were indicated after controlled drugs had been administered. We were informed by a senior support worker that none of the residents were self administering medication at the time of the inspection. There was documented evidence that medication training had been delivered to support workers. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is satisfactorily detailed and people are being protected from abuse. EVIDENCE: The complaints procedure was clear, concise and written in a format suitable to meeting the needs of people who use the service. The complaints book was viewed and reflected that complaints had not been received following the last inspection. Accidents and incidents were being recorded and related risk assessments were carried out. Regulation 37 forms were completed and faxed to the CSCI where appropriate. Incident behavioural charts in relation to each resident were in place. We were informed by a senior support worker that state benefit was paid into people’s separate bank accounts. Personal allowances were held in safekeeping at the home but each bedroom contained a lockable facility for securing cash and/or valuable items. Separate financial records were inspected at random but no discrepancies were identified. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 17 Records were reflective of staff training of Safeguarding Adults being delivered. Policies and procedures regarding the protection of vulnerable adults were in place. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26 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 clean, hygienic and very well maintained. Residents’ bedrooms are appropriately fitted and personalised. The environment is pleasant, lively and homely. EVIDENCE: The communal areas at the home are spacious, in good decorative order and all furniture, fittings and equipment are of very good quality. The garden is being maintained and accessible to residents. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 19 The laundry is appropriately equipped and no issues were identified. All bedrooms are suitably furnished and fitted, contained en-suite bathroom facilities and were reflective of individual choices and interests. Overall, the home was clean, hygienic and very well maintained. The environment is bright, homely and lively. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support workers are qualified and have received appropriate training for meeting the needs of people who use the service. The recruitment policy and practices are satisfactory. EVIDENCE: We were informed by the Manager Designate and also indicated on the completed AQAA, that of ten permanent care staff employed at the home, three had achieved NVQ level 2 or above and two were receiving NVQ training. A number of staff recruitment files were viewed at random and each file contained all required documents. Individual training programmes were in place and reflected that induction training was provided to all new care staff. Regular training and refreshers for Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 21 meeting the needs of residents were subsequently delivered and included Mental Health Awareness and Challenging Behaviour. Four support workers were spoken with. All reported ‘good team working’ among staff and a ‘family environment’ within the house. Support workers were observed being friendly in their interactions with residents, and competent and attentive in meeting their needs. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager Designate is appropriately qualified and experienced. The AQAA – self assessment has been completed as required. The health and safety of people who use the service are being protected. EVIDENCE: The Manager Designate has had five years managerial experience and has obtained the Registered Manager’s Award. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 23 Support workers spoken with reported that the Manager Designate was approachable and supportive and operated an open door policy. Staff and residents were observed freely entering the office and relating in a friendly manner with the Manager Designate. An Annual Quality Assurance Assessment (AQAA) was satisfactorily completed and returned to the CSCI. What was done well and areas requiring improvement were identified and evidenced. Numerical information was also provided. Health and safety records viewed were up-to-date. Fire drills were regularly undertaken and clearly detailed. Environmental risk assessments were in place. Training records were reflective of staff training being delivered on Health and Safety, Food Hygiene, Fire Safety, First Aid and Moving and Handling. Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 4 5 CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 X X 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 X 3 X ENVIRONMENT Standard No Score 24 3 25 4 26 4 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000069305.V366908.R01.S.doc LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 4 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bear Road (82) Score 3 3 4 X 3 X 3 X X 3 X Version 5.2 Page 25 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bear Road (82) DS0000069305.V366908.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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