Care Home: Brentside Cottages

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What the care home does well The home provides a service to people who have different cultural and religious needs. This is reflected in a diverse staff group. The needs and aspirations of prospective residents are comprehensively assessed by the service prior to placement. Contact between residents and relatives are encouraged and facilitated, and interested relatives are informed of daily events. The health needs of residents are promptly and appropriately met. Medication procedures are fully followed. Health and safety records are maintained satisfactorily and indicative of the health, safety and welfare of residents being protected. Training and refreshers for meeting the needs of people who use the service are regularly delivered to support staff. Residents were clean, tidy and appropriately dressed. They appeared settled and content within their environment and reported being happy at the home. Overall, the premises were clean, hygienic and reasonably well maintained. The environment was calm, pleasant and homely. What has improved since the last inspection? On requirement at the last inspection had been been complied with. Specifically, staffing levels are appropriate for meeting the needs of people who use the service. What the care home could do better: Care plans must be reviewed on a regular basis. Weight charts that are currently in place should be maintained. Updated copies of the service user`s guide must be made accessible to residents and relatives. Blown light bulbs must be replaced. Apart from fresh fruit, snack choices offered to residents should also include biscuits, cake and/or crisps. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Brentside Cottages 80 Ruislip Road East Ealing London W13 0AL     The quality rating for this care home is:   two star good 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: 2 0 0 8 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. that people have said are important to them: They reflect the things 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 © (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. www.cqc.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: Brentside Cottages 80 Ruislip Road East Ealing London W13 0AL 02089919668 02089919668 hm80ruislip@ealing.org.uk www.supportforliving.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Support for Living care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 3 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: Mental Disorder, excluding learning disability or dementia - Code MD Learning disability - Code LD Date of last inspection Brief description of the care home Brentside Cottages is a residential care home for three adult female service users with learning disabilities and/or mental health issues. It was first registered in 1994 as a small home, under the Registered Homes Act 1984 and 1991 Amendment Act. The Registered Providers are Support For Living. Acton Housing Association owns the property and is responsible for the maintenance. There is a Registered Manager and a Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 3 3 Brief description of the care home team of support workers who provide care personal and practical support to the service users. The home is a detached property, which was converted from two cottages. It is situated on Ruislip Road East adjacent to the swimming pool. There are local shops nearby, and the shopping centres of Greenford and Ealing Broadway can be reached by public transport. The accommodation consists of three single bedrooms, one of which is on the ground floor. There is a lounge and a separate dining room. The office/sleeping in room is on the first floor. There is a shower and toilet, on the ground floor, and a bathroom and toilet on the first floor. The kitchen and the laundry are on the ground floor. There is a patio area with garden furniture and a good size garden to the rear and in front of the home. 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: 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 peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out between 11:00 am and 4:00 pm on 20th August 2009. A support worker and one resident were initially present. We were informed by a support worker that a service was being provided to two people and an individual was attending a drama session. The Registered Manager was on annual leave. We were subsequently joined by a representative of the organisation who was previously a Registered Manager of the home. During the course of the inspection: records, documents, policies and procedures in relation to Key Standards were examined. A tour of the building was undertaken and observations were made. Care Homes for Adults (18-65 years) Page 6 of 29 Discussions were held with a support worker and two residents were spoken with. We received co-operation and assistance from a representative of the organisation during the majority of the inspection. A requirement made at the last inspection and all key Standards were examined. The homes annual quality assurance assessment (AQAA) was considered. 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. Care Homes for Adults (18-65 years) Page 8 of 29 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 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 needs and aspirations of prospective residents are assessed comprehensively assessed prior to placement. The service users guide was not accessible. Evidence: The personal files of two residents were viewed. Each file contained documented evidence that the needs and aspirations of residents were comprehensively assessed by the service prior to placement. It was indicated also, that prospective residents, relatives, social workers and health professionals were involved in the process assessing and determining the capacity of service to meet separate identified needs and aspirations. The service users guide was not accessible for viewing at the time of the inspection. There were also, no indicators that copies of the service users guide had been provided to residents. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: Care Homes for Adults (18-65 years) Page 12 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. Although care plans are satisfactorily drawn up, they are not being regulaly reviewed. Risk assessments are carried out satisfactorily. Residents are supported in maintaining their independence, where appropriate. Evidence: Care plans regarding two residents were examined. It was reflected that individual personal, social, cultural, religious and physical, emotional and mental health needs were assessed. There were, however, no indicators that reviews of care plans were being undertaken on a regular basis. The last recorded reviews were dated lst July 2008 and 17th July 2008. Risks in relation to specific activities were assessed. These included moving and handling, eating and drinking and entering the kitchen without assistance from staff. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: We were informed by a support worker that residents were encouraged to make decisions regarding day-to-day routines such as what they wore each day, activities and meals. A resident proudly showed us his/her handbag and produced personal contents including a purse containing minimal cash. Another viewed a magazine of choice purchased at the time of the inspection. Residents were observed moving freely around the house. Individual interests and choices were reflected in personalised bedrooms. Care Homes for Adults (18-65 years) Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The separate religious and cultural needs of people who use the service are being met. Residents are supported while participating in shared or individual activitity in the community. Varied and nutritious meals are provided to residents. Residents are able to maintain contact with relatives and/or friends. Residents are able to undertake house keeping tasks were appropriate. Varied and nutritious meals are being provided. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: We were informed by a representative of the organisation, that a resident was taken to a Christian Church by a relative each Sunday. Another was supported by care staff during regular weekly visits to the temple. An activities programme was on display and indicated residents attended the day centre on specific days in each week. They were also supported in various shared and/or separate activities in the community such as day trips, walks in the park and visiting the cinema. A resident attended a drama session and another was supported during a brief shopping trip to a local shop, at the time of the inspection. Residents were observed reading and/or viewing television in the homes lounge. Contact between residents and their respective relatives and/or friends are encouraged and facilitated. A representative of the organisation confirmed that regular contact with interested relatives included weekly home visits. It was reported by a suppport worker that residents were supervised while undertaking housekeeping tasks such as bringing down laundry, preparing vegetables and clearing dining table. Menus were reflective of varied and nutritious cooked evening meals, including cultural options, being provided to residents. Cereals were offered at breakfast and light options such as sandwiches were prepared for lunch. Residents were seen requesting and having tea with fresh fruit. However, an individual refused an afternoon cup of tea after he/she was denied a biscuit. We were informed by a support worker that the decision was based on healthy eating being promoted at the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and health care needs of people who use the service are met appropriately. Medication procedures are being fully followed. Evidence: The personal needs of residents were reflected on individual care plans and indicated that people who use the service required assistance and/or supervision with personal care. A support worker confirmed that the privacy and dignity of residents were at all times respected and they were able to choose what they wore each day. Residents appeared clean, tidy and appropriately dressed. There was recorded evidence that people received access to health professionals as/when required and were accompanied by relatives and/or care staff to medical appointments. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Routine well woman, dental and eye checks were arranged. Individual weight charts were in place but were not maintained. The records indicated that residents were last weighed on 4th January 2009. Policies and procedures on medication were in place. All medicines were safely and appropriately stored and medication administration sheets were accurately documented and signed. Records of medicines received and returned to the Pharmacist were in place. We were informed by a support worker that people who use the service lacked capacity to self-administer medication. There were documented indicators that medications stored at the home were audited by Boots Pharmacists on a four monthly basis. Staff training records were reflective of Boots accredited training on Care of Medication being delivered to all care staff. 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 satisfactory and residents are protected from from abuse and neglect. Evidence: The complaints procedure was in place and written/illustrated in a format suitable for meeting the needs of the people who use the service. There was no recorded indicators of complaints following the last inspection. This was confirmed by a representative of the organisation. We were informed by a representative of the organisation, that state benefits were paid directly into separate bank accounts and personal cash allowances were being secured by care staff on behalf of residents. Individual financial records were examined and no discrepancies were identified. Accidents and incidents were appropriately recorded and notifications were submitted to the Commission where required. Policies and procedures on Safeguarding Adults, inclusive of Whistle Blowing were in place and comprehensively detailed. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: A training and development programme was viewed and indicated that staff training on the Safety of Vulnerable Adults had been delivered. 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 premises are clean, hygienic and reasonably well maintained. However, suitable lighting is not provided in all areas of the premises. The environment is calm, pleasant and homely. Evidence: The premises are adequately spacious and suitable for shared and/or individual activitity. All furnishings and equipment are appropriate and of good quality. There was recorded evidence that areas requiring repairs were being noted and received appropriate attention. A Plumber called regarding a leakage in the bathroom on the first floor at the time of the inspection. However, light bulbs in the kitchen, dining room and medication cupboard had blown and were not replaced. The garden was adequately maintained. No issues were identified in relation to the laundry. Overall, the home was clean, hygienic and reasonably well maintained. The environment was calm, pleasant and homely. Care Homes for Adults (18-65 years) Page 21 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. Staffing levels are appropriate and care staff are suitably trained and qualified for meeting the needs of people who use the service. Recruitment files were not accessible at the time of the inspection. Evidence: Duty rotas were indicative of between one and three support workers being on duty during waking hours and was dependent on activities planned. There was one sleep-over at night. One support worker covered a long day and night shift at the time of the inspection. A representative of the organisation and a support worker confirmed that this was due to staff training. There was documented evidence to that effect. We were informed by a representative of the organisation that of six permanent support workers, four had achieved NVQ level 2 and/or above. This was reflected on the homes AQAA. The Registered Manager was not present at the time of the inspection and as a Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: consequence, staff recruitment files were not accessible. A training and development programme was in place. It was indicated that care staff received appropriate training and refreshers for meeting the needs of people who use the service. These included Handling People with Special Needs, Disability Awareness and Choking and Resuscitation. Care Homes for Adults (18-65 years) Page 23 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 appropriately trained and qualified. Quality assurance has been undertaken satisfactorily. The health, safety and welfare of people who use the service are being protected. Evidence: The Registered Manager is suitably experienced and qualified in her role. A support worker confirmed that the Registered Manager as approachable and supportive. The service has submitted to the Commission, their annual quality assurance assessment (AQAA). It was clear and all required information was provided. Health and safety records were up-to-date and included fire safety and water temperature checks. Clear water/legionella testing, portable appliances tests and gas Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: maintenance. There was recorded evidence that fire drills were undertaken on a three monthly basis. Environmental risk assessments were in place. It was reflected on training records that care staff received training and refreshers on Moving and Handling, Health and Safety, Fire Safety, First Aid and Food Hygiene. Policies and procedures on Health and Safety were in place and appropriately detailed. Care Homes for Adults (18-65 years) Page 25 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 26 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 1 5 The Registered Person must make sure that updated copies of the service users are provided to residents. This is to ensure that people are suitably informed of the service provision. 31/10/2009 2 9 17 The Registered Person must make sure that care plans are reviewed on a regular basis. This is to ensure that the needs of residents are being met. 09/10/2009 3 24 23 The Registered Person must make sure that light bulbs are replaced when required. This is to ensure that there is suitable lighting in all areas of the premises, at all times. 30/09/2009 Care Homes for Adults (18-65 years) Page 27 of 29 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: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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