Care Home: Chapel Lane, 74

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What the care home does well The residents are involved in the formulation and review of their service user plan. Complaints and safeguarding systems are in place and staff are aware of these. Comments received from residents in the surveys included: `The staff listen to us, we have choice and the home respects my wishes`. `Lots of respect and choice. They look after all aspects of our day to day living`. `The Home supports me well with my personal care and health needs`. Comments received from staff in the surveys included: `We encourage the residents to be individuals and as independent as they are able to be`. What the care home could do better: Some shortfalls were identified with medication management, which should be easy to address. We found shortfalls in the environment. The kitchen requires refurbishment, and work is needed to the patio area. Comments received from residents in the surveys included: `Plan more trips out at the week-end`. `Would like to go out more in the community`. Comments received from staff in the surveys included:`Be more flexible and pro-active to allow residents to access the community more frequently`. `Communication with each other in the team`. `Improve on the staffing levels`. Random inspection report Care homes for adults (18-65 years) Name: Address: Chapel Lane, 74 Chapel Lane, 74 Hillingdon Middlesex UB8 3DS three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rekha Bhardwa Date: 2 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Chapel Lane, 74 Chapel Lane, 74 Hillingdon Middlesex UB8 3DS 01895446958 01895440826 mhowell@hillingdon.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Anne Howell Type of registration: Number of places registered: Conditions of registration: Category(ies) : London Borough of Hillingdon care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: 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 The home provides a service for six people with learning disabilities. The property is owned by Shepherds Bush Housing Association and the care is supplied by London Borough of Hillingdon. The house is a large detached family residence, which has been extended. The house is situated in a quiet residential avenue in Hillingdon that is Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home within easy reach of public transport links to central Uxbridge and other shopping centres in the area. There are a few local shops within walking distance. All of the six bedrooms are single occupancy and have wash hand basins. There is no lift in the home. The ground floor accommodation comprises two bedrooms and all the shared communal facilities. There is a very large lounge with dining area and access to the garden via French doors. The garden is wheelchair accessible and there is a wheelchair accessible showertoilet on the ground floor as well as a large domestic kitchen, laundry and office. The first floor has four bedrooms, a shower, bathroom and a toilet. The stairs are fitted with support rails. The home is accessed at the front by ramp and new ramps now give wheelchair access to the rear garden. The home has a minibus used for outings with residents contributing to the cost. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: This was an unannounced random inspection carried out as part of the regulatory process. A total of 3 hours was spent on the inspection process, and was carried out by 1 Inspector. We carried out a tour of the home, and a service user plan, medication records and a sample of servicing records. Residents and staff were spoken with as part of the inspection process. The Annual Quality Assurance Assessment (AQAA) document completed by the home has also been used to inform this report. We sent out a selection of surveys for residents and staff. Feedback from these have been included in the report. The last key inspection of this home was carried out on 6/6/07. The home uses the Boots Monitored Dosage System for medication management. At the time of the inspection four residents were receiving medication. No residents were able to administer their own medication. We viewed the Medication Administration Records (MAR). With the exception of one medication all medications received into the home had been receipted. Records of returns were also available. For one resident who had refused their medication the appropriate code had been used. Cupboard temperatures were being taken daily and the staff were clear which medicines required to be stored in the fridge. We found that the staff signature list only documented the sample initials of staff administering medication. We recommended that this is reviewed and that a sample of the staff members signature is also maintained. We have also recommended that each resident have an up to date medication profile. We found that there was a bottle of olive oil ears drops that was out of date and suggested that this was returned to Boots. A daily stock check of as required medications is carried out at the change of each shift. We noted that there was a shortfall for one residents paracetamol balance that had been identified, but no follow up action had been recorded. Only staff that are senior care workers can administer medication. All staff who administer medication have undertaken training in this area. We viewed one service user plan. This detailed the needs and the support required by the resident. We found that there had been input from the resident and their representative in the development of the care plan. A moving and handling assessment had been completed, and this is reviewed annually or sooner if the needs of the resident change. The AQAA completed by the service confirmed that there had been no complaints or safeguarding referrals in the last twelve months. Staff also confirmed that they had received safeguarding training and that they were aware of whistle blowing procedures. The AQAA detailed that staff had received training and have guidelines on managing residents behaviour. The staff also have access to the boroughs Positive Behaviour Unit for help, support and advice on managing residents behaviour. We carried out a tour of the home and garden areas. The home is a detached 6 bedroom house. There is a large garden to the rear which can be accessed through the lounge and the laundry room. Generally the residents bedroom areas were being well maintained, and staff had spent time with the residents personalising their bedrooms. The lounge carpet was worn and was badly stained. The interim manager informed us that Care Homes for Adults (18-65 years) Page 4 of 10 Shepherds Bush Housing Association had agreed to replace this. We found that several doors throughout the home were wedged open, this is not good practice and could potentially be unsafe in the event of a fire. The kitchen was showing signs of wear and tear. The cupboards doors on many of the units did not close properly and some of the cupboard surfaces were damaged and could potentially be difficult to clean and pose an infection control risk. The patio area in the garden in some areas was raised and could potentially be a trip hazard for the residents. The AQAA detailed that the housing association has a cyclical decorating programme. We were informed at the inspection that the manager was on sick leave and that management arrangements were in place to oversee the running of the home. Each shift has a senior care worker on duty. The interim manager spoke with us during the inspection and confirmed that she would be making regular visits to the home. What the care home does well: What they could do better: Some shortfalls were identified with medication management, which should be easy to address. We found shortfalls in the environment. The kitchen requires refurbishment, and work is needed to the patio area. Comments received from residents in the surveys included: Plan more trips out at the week-end. Would like to go out more in the community. Comments received from staff in the surveys included: Care Homes for Adults (18-65 years) Page 5 of 10 Be more flexible and pro-active to allow residents to access the community more frequently. Communication with each other in the team. Improve on the staffing levels. 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 2. Care Homes for Adults (18-65 years) Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 10 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, 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 20 13 All medications which have expired must be returned to the pharmacist. This is to ensure that medications are disposed of correctly. 05/07/2010 2 20 13 Where shortfalls have been identified in stock balances this must be investigated. This is to ensure that medications are being managed safetly. 05/07/2010 3 20 13 Receipts for all medications 05/07/2010 received into the home must be recorded. This is to ensure that there is a clear audit trail of medication. 4 24 23 Where doors are required to be kept open, they must be fitted with a self-closing mechanism. To maintain the safety of the residents and staff. 30/07/2010 Care Homes for Adults (18-65 years) Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 5 24 23 The kitchen must be refurbished and replaced. In order that residents have a well maintained environment to live in. 31/12/2010 6 24 23 The patio area must be made 30/07/2010 safe. To ensure the safety of residents and staff. 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 2 20 20 The staff initial list should be updated to also reflect staff signatures. All residents should have an up to date medication profile. Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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