Care Home: Bishops Road, 89

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What the care home does well Bishops Road provides a homely and comfortable environment for people. People have a care plan and health action plan that covers how their needs will be met with the support of staff. People who live at the home said they liked it and were able to talk about their interests and routines which the home supports. What has improved since the last inspection? Care records are up to date and a clear system is in place for recording and monitoring peoples finances. What the care home could do better: A Manager needs to be appointed and put forward for Registration with Commission for Social Care Inspection (Quality Care Commission from April 2009). This will ensure the continued improvement of the home for people who use the service. Quality Assurance monitoring must take place and an action plan developed. The staff team should look at ways in which people who live in the home may develop their self help skills particularly in the kitchen to enable them to have more autonomy. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bishops Road, 89 Bishops Road, 89 Hayes Middlesex UB3 2TG two star good service The quality rating for this care home is: 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: Susan Woolnough-Singh Date: 2 7 0 1 2 0 0 9 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Bishops Road, 89 Bishops Road, 89 Hayes Middlesex UB3 2TG 02085610260 02085610260 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Life Opportunities Trust Name of registered manager (if applicable) Ms Linda Hanaghan Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 0 care home 5 learning disability Additional conditions: 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 The maximum number of service users who can be accommodated is: 5 Date of last inspection A bit about the care home Bishops Road is a home registered to give board and personal care for five adults with Learning Disabilities. The home is operated by Life Opportunities Trust and owned by Shepherd?s Bush Housing Association. It has been registered since 1996. The home is situated in a residential area on a bus route, close to shops, day centres, clubs and other local amenities. Three service users attend day care services. One service user has made a positive choice not to attend day care services. The home has a small garden area that service users use when the weather allows. The home does not offer any respite care. 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: two star good 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 How we did our inspection: This is what the inspector did when they were at the care home This was a key inspection of Bishops Road. The Key National Minimum Standards for Adults were assessed. Visits to the home took place on three separate occasions. We visited the home on 19th January 2009 where we toured the building and looked at care records. A visit was made to the home on Saturday 24th January to meet with people who live at the home. We met with the Manager of the home on 29th January to view personnel records and look at quality assurance. We talked with three people about their life in the home and received a number of questionnaires. Four questionnaires were received from staff and five from people who live at the home. Although very few additional comments were made on the questionnaires they indicated that people were satisfied with the service at Bishops Road. What the care home does well Bishops Road provides a homely and comfortable environment for people. People have a care plan and health action plan that covers how their needs will be met with the support of staff. People who live at the home said they liked it and were able to talk about their interests and routines which the home supports. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Susan Woolnough-Singh 33 Greycoat Street London SW1P 2QF 02079792000 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 240 7535 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 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 . Information is available for people about the home in the Statement of Purpose. People have their needs assessed by the Commissioning Local Authority. Evidence: We looked at the Statement of Purpose which containes information on the support available in the home and includes information on visiting arrangements, staff training and complaints. The Statement of Purpose states what people can expect with regard to life at Bishops Road. We looked at the care files of three people who use the service. All of the people living at the home at the time of the inspection had done so for a number of years. Therefore we did not view any new Needs Led Assessments during this inspection. Arrangements for people who live at the home are normally made by the Local Authority who carry out a Needs Led Assessment. 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 . People have a care plan which covers their personal needs. People make their own decisions with regard to daily routines in the home. Risks assessments are completed for the activities of daily living. Evidence: We looked at the care records of three people who live at Bishops Road. These contained the care plan, health action plan, person centered plan and risk assessments. The care plan covers the support to be given as part of the persons daily routine and includes social care, personal care, self help, communication and mobility. The care plans seen were recent and dated December 2008. We spoke with three people who live at Bishops Road about their routine and life in the home. Their views are covered in Standards 12 - 17 Lifestyle. Overall it was clear from the information and examples given by people that decision making with regard to daily routines and social activities is encouraged. We looked at a number of risk assessments in the care records we viewed. These generally fell into three categories; general risk assessments for activities taking place in the home, mobility assessments and assessments with regard to any behaviour that may have negative consequences for the person or others. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at the home attend a Day Service and have contact with family and friends. People are not actively supported to prepare their own drinks and snacks. This is to be recommended. Evidence: We visited the home on Saturday 24th January to talk with people living in the home. We spoke to them about friends and family, their living environment, staff at the home and their leisure activities. From these conversations we gathered that people participate in the community and see friends and family, or are in th touch with them. People had different levels of family contact. People also had different interests for instance one person very much liked his/her bedroom and another had more of a social life and contact with friends and family. We met with people in private in their bedrooms and observed that these were furnished to a high standard and personalized. The care plans and person centered plans also reflected peoples choices. We were able to see from these records that people attended a day service and some people attended specialist clubs in the evening. One person spoke of a change in the arrangements for his/her day service and plans for the future. Evidence: Staff cook varied meals for people who use the service. One person spoken with said they had enjoyed their lunch. We ascertained that generally staff are responsible for cooking the meals, this was also observed. Meals are served in the lounge/dining room, this was seen to be a pleasant and homely environment. We observed that one person requested a hot drink on two occasions and a member of staff asked them to wait until later. On the second occasion it was requested by a senior manager that this be provided. We spoke with the Manager with regard to the above and recommended that people be encouraged to help themselves therefore not being so reliant on staff. We discussed peoples abilities and recognized that some people lacked confidence in the kitchen or a risk was involved. We strongly recommended that the staff team look at peoples self help skills to identify areas where they could be more involved in the kitchen and any other areas, to increase independence. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The health care needs and personal care needs of people are identified in the care plan and met. There are systems in place for the safe management of medication. Evidence: We were able to see from the care plans that the personal support people require is noted .and that people need different levels of this. Each person also has a Health Action Plan and a record is made of appointments with health care professionals. The Health Action Plan covers areas such as physical and emotional health and routine bodily care. The appointments listed demonstrated that people had attended chiropody, dental and general practitioner appointments. Specialist appointments had been made and routine screening appointments where necessary. Life Opportunities Trust Medication Policies and Procedures are available for staff. People who live at the home are not responsible for their own medication. We examined the medication cabinet and medication administration records. A monitored dosage system is used. The medication cabinet was kept in good order and administration of medication had been signed for. A Primary Health Care Trust Pharmacist Audit had taken place. We discussed this with the Manager and were unsure if some of the recommendations had been followed. The audit report did not highlight any major ares for concern. The administration of medication is audited by the Service Manager, for this a Life Opportunities Trust Audit prompt is available this covers all areas from storage to staff training. We recommend that recommendations from external audits are incorporated as part of internal management audits. Evidence: 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 . Information on complaints and protection is available for people who live in the home and for the guidance of staff. Evidence: Life Opportunities Trust has policies and procedures in place for complaints and safeguarding vulnerable adults. There is clear pictorial information available for people who use the service on the meaning of abuse and the people to be contacted to report this. No complaints had been made since the last Key Inspection. We were able to examine the method of managing peoples finances to check that systems were in place. People in the home require support in this area. A record is made of regular expenditure for every day items, included in this is a description of the items purchased and a running balance. Two staff sign when financial records are administered and a service manager is responsible for auditing the accounts. A recruitment procedure in in place which incorporates checks on prospective members of staff. More detail is contained under standard 34 - recruitment. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Bishops Road provides and excellent environment for people, which is well maintained and comfortable. The home is cared for and clean. Evidence: We toured the building and were able to view peoples bedrooms. We were able to see that all parts of the home are very well cared for. The home is furnished and decorated to a very high standard. The environment is light and fresh and looks homely. All parts of the home seen were kept to a high level of cleanliness, this including the kitchen and the laundry. We were able to view peoples bedrooms. These are all individual and personalized with good quality furniture, fixtures and fittings. People said that they like their bedrooms. 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 . The recruitment and selection procedure is aimed at the protection of people who use the service. Evidence: A small staff team are in place at Bishops Road. A core of staff have worked at the home for a number of years and know people well. We were informed that the home is fully staffed apart from a Registered Manager. An acting Manager is in place whilst Life Opportunities Trust endeavor to select a Manager for registration. A minimum of one member of staff works on shift with one member of staff sleeping in overnight. One two of the days that the home was inspected two staff were on duty. The third visit was for a meeting with the manager only. We looked at the recruitment file of the must recent member of staff to join the team. This contained identity verification with a photograph, three references, medical reference and Criminal Records Bureau information. We received four completed surveys from staff who work at the home. Questions with regard to staff support and training were responded to positively. One person commented that high standards of training are maintained. We received confirmation from the Manager on training. This information told us that all staff had received mandatory training in moving and handling, first aid, food hygiene and fire safety. New staff receive in house induction training for six weeks where polices and procedures are looked at ; further to this an induction course takes place at head office. Safeguarding adults, health and safety and supervision are included in this. We did not look at National Vocational Training on this occasion. 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 home is being run for the benefit of people who use the service. The recruitment of a permanent Manager is necessary to ensure the continued improvement of standards at Bishops Road. There was no clear evidence of regular reviews of quality monitoring. The are procedures and practices in place for the monitoring of health and safety in the home. Evidence: At the time of the inspection a Registered Manager from another Life Opportunities home was working at Bishops Road for two days a week. This being a temporary arrangement until a permanent manager is recruited. We met with the Area Service Manager on the second day of the inspection and were advised that a candidate for this post had been identified. During the process of this inspection there was not sufficient evidence to verify that Quality Assurance monitoring had taken place, this is partly due to the fact that a Registered Manager is not in place. There is a system for monitoring quality standards in the home and we were informed that this would be started. We observed during the inspection that the home is clean and safe. People who live at Bishops Road have risk assessments for some activities. We looked at the fire safety records. Fire alarm and fire equipment had been serviced in 2008. Four fire drill Evidence: evacuations had taken place since October 2008. Weekly fire alarm testing had been recorded. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 39 24 The Responsible Individual and the Manager of the home must ensure that quality of care is assessed and reviewed. 11/05/2009 Standards in the home must be monitored for the benefit of people who use the service 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 1 17 Staff should actively encourage people to participate in the preparation of drink and meal preperation. We recommended that the audit of medication administration incorporates the periodic pharmacy assessment. 2 20 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 © (2009) 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. 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