Care Home: Clover Residents

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Townley Road, 2-3
• Chatsworth Care - Tudor Lodge

What the care home does well The home provides consistent and stable support for people; there is a small staff team. we talked with the Registered Manager and a member of staff on duty, who both spoke extensively about individual care needs. We judged that staff had a good knowledge of these. There is a schedule of social activities and one person receives one to one support from a member of staff during the day. The home acknowledges equality and diversity issues and has sought to meet the various needs. What has improved since the last inspection? Four requirements were made at the last Inspection in September 2009. These have all been met. In 2007 we required that the home is maintained to a good standard and radiators be covered for health and safety reasons. We required an improvement in medication administration records and the presentation and content of care plans. What the care home could do better: We have made a number of good practice recommendations as a result of this inspection visit. We have recommended that the Registered Manager look at ways in which to improve the ambiance of the home particularly the living room and dining room, to make these more personal. We also recommend that a Quality Assurance format be developed to enable the Registered Manager to monitor the home against the National Minimum Standards. The home has identified in the (AQAA) the need to improve the presentation of records and to offer more support to people for social activities. Key inspection report Care homes for adults (18-65 years) Name: Address: Clover Residents 2 Dorchester Drive Bedfont Middlesex TW14 8HP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Susan Woolnough-Singh     Date: 0 5 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 25 Information about the care home Name of care home: Address: Clover Residents 2 Dorchester Drive Bedfont Middlesex TW14 8HP 02088931123 02088931123 cloveresidentsltd@talktalk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Deborah Selley,Denise Avril Files 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 categories 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 Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Clover is a three bedded home for three residents. It is registered for people with learning disabilities. The home is a detached bungalow, situated in a quiet cul-de-sac. It is within easy walking distance of Bedfont, where there are shops and public transport links. Hounslow town shopping centre and Feltham leisure facilities can be easily accessed from the home. Accommodation includes a large lounge/dining room and three single bedrooms. There is one bathroom with a toilet for the residents. The Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 0 3 3 Brief description of the care home bedrooms do not have washbasins. The office/sleeping - in room has its own shower and toilet. There is a small garden around the bungalow with seating. Fees vary and are dependant on the assessed resident?s needs. Care Homes for Adults (18-65 years) Page 5 of 25 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 was an unannounced inspection carried out as part of the regulatory process. The inspection visit took place on 11th September 2009, and the 28th September 2009. We met with two people who live at the home and one member of staff. On the second visit we met with the Registered Manager/Proprietor of the home, at a later date we spoke with one person on the telephone to ask him about life in the home. We viewed samples of care files, staff employment files and maintenance records. The Registered Manager assisted with the inspection process and had completed an Annual Quality Assurance Assessment, providing information about the home. All of the National Minimum Standards were assessed during this inspection. Care Homes for Adults (18-65 years) Page 6 of 25 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 on page 4. 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 7 of 25 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 8 of 25 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 on the home and the care services offered. People have their care needs assessed prior to moving into the home. Evidence: The Annual Quality Assurance Assessment (AQAA) which was completed by the Registered Manager informed us that the Service Guide and Statement of Purpose are available in large print. This standard has been assessed and met at previous inspections. There have been no new admissions into the home since the last key inspection. The last person to move into the home did so in 2006. We were able to see that this person had an assessment completed by the placing Local Authority. Care Homes for Adults (18-65 years) Page 9 of 25 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 care plans where their assessed daily needs are reflected. We have made a good practice recommendation with regard to the keeping of these records in individual files. People are supported to make daily decisions about their lives. People are able to take risks and risk assessments are completed to ensure the staff team are aware of the potential. Evidence: We viewed the care plans of two people living in the home. A statutory requirement was made at the last inspection for care plans to be written clearly and indicate peoples needs. We examined closely, the care plan and risk assessments of one person who has complex needs. The care plan contains information on health care needs and appointments, activities, behavioral guidelines and risk assessments. People have had their care reviewed and we were able to see a record of this and that Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: care was being monitored by the placing Local Authority. We met with two of the three people living at Clover. One person was out during the inspection visits to the home. However, we made contact by phone to ascertain his views on life in the home. Two people were at home, both with very differing needs. We observed how staff endeavored to communicate with one person, where language is a barrier, part of this communication was to provide structure and boundaries. One person had an age related condition and did not seem to require the same level of activity. The person we spoke with on the phone has a more independent lifestyle and he informed us that he would like to have a job. We discussed with the Registered Manager the work that had been done to find and provide links with the community of one person and to recruit a care worker of the same ethnicity. The placing Local Authority had also been involved in this. The Inspector viewed a sample of risk assessments, the assessments for one person with complex needs, in particular, was looked at in detail. We were able to see that behavioral risks had been identified and behavioral guidelines were in place. Care plans, risk assessments and other related records are held in a file for each person. We recommend that these be updated and streamlined to contain current information and give easy access of information. Care Homes for Adults (18-65 years) Page 11 of 25 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 are able to engage in social activities both in the home and in the community. People are supported to maintain social relationships. The meal provision is varied and caters for individual needs and preferences. Evidence: We looked at the daily schedules for people, these are completed on an individual basis. These covered day services, leisure activities and house keeping tasks. Two people attend a Day Centre during the week, one person does not and the reasons for this were explained. Staff aim to provide activity during the day for the person who does not have a daily structure. This includes frequent trips out with his Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: key worker, particularly to shopping areas in the West London where he is ale to have some link with his community. We could see from the two activity programmes that one person has regular contact with family and one person goes to the Gateway Club regularly. There is a pub meal out once a week. One person has specific cultural needs and has a separate fridge and cupboard for his food. There are lists of common foods and the name of them in his primary language and English, this helps with communicationin in regard to meals. We received a copy of the menus and were able to see that this is varied with some meals out and takeaways. Care Homes for Adults (18-65 years) Page 13 of 25 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. People receive personal support in their preferred way. The health needs of the people were being met. Medication is stored and administered safely. A good practice recommendation has been made for information on medication records. Evidence: People need different levels of support when managing their personal care. Personal care support is provided in private. There is information on personal care in the care plan. We became aware that the family of one person had requested a male carer of the same ethnicity as his son. In discussion with the Registered Manager we ascertained that this had been acknowledged by the home and Local Authority. Work had been carried out to progress this request but to date a candidate of the right caliber had not been identified. Health needs are met with people seeing a range of health professionals, such as Psychiatrist, Psychologist and GP. Medical appointments are recorded. We were able to Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: see from placement review minutes that health care is monitored. We viewed medication storage and examined the recording of administration. Medication is locked in a secure cupboard, but it is not a metal medication cabinet. Medication is stored in individual plastic containers, in an orderly fashion. We looked at the Medication Administration Records for two people and there did not appear to be any omissions with administration recording. One person receives PRN medication. We discussed this with the Manager who said that staff recognize behavioural symptoms that require this medication and that they will contact her by telephone prior to administration. We recommend that more information be inserted into the medication records to ensure that it is explicit when this medication is to be considered for administration. The Pharmacy Inspector for the home had assessed medication standards in March 2009. Care Homes for Adults (18-65 years) Page 15 of 25 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. A complaints procedure is available for people and their families. There is guidance policies and procedure for staff on report safeguarding incident. Evidence: The home has information on how complaints may be made and a Whistle Blowing Policy for staff. People have a copy of the complaints procedure in their bedrooms. The London Borough of Hounslow protocol for reporting a safeguarding of vulnerable adults incident is in place. We had not received any information to indicate concerns with regard to complaints or safeguarding affecting the welfare of people who use the service. The home forwards Incident Notifications to the home as and when required. There have been no adult abuse investigations or concerns in the home. Staff receive regular training on this subject. Peoples financial autonomy is related to their capacity to mange their finances and different levels of support are offered. We did not examine records on this occasion. We discussed with the Registered Manager the management of peoples finances. We discussed the process used for one person who has more autonomy with daily financial management. Care Homes for Adults (18-65 years) Page 16 of 25 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. Improvement have been made to the home which is spacious and well maintained. We recommended that the communal areas of the home are further improved. Overall the home was clean and hygienic. Evidence: Two statutory requirement were made at the last inspection, namely that the home must be maintained to a good standard and the radiators be covered for the safety of people who use the service. The requirements had been met. The (AQAA) informed us that the kitchen and the front of the home had been decorated, equipment in the laundry and the boiler had been replaced, and door guards had been fitted to all fire doors. We carried out a tour of the home and all rooms were viewed. The home was found to be clean, tidy and spacious. We recommended that the Registered Manager look at ways to enhance the communal areas of the home by making them more personalized. We looked at two bedrooms and could see that one reflected the persons interests and Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: preferences. One room was functional only, a full explanation for this was given and accepted. Care Homes for Adults (18-65 years) Page 18 of 25 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 home is appropriately staffed to ensure that the needs of people can be met. Systems for vetting and recruitment practices are in place for the protection of people who use the service. The training programme in place meets the needs of the staff team and consequently the needs of people, who live at the home, Evidence: The home has a small staff team consisting of the Registered Manager and four residential care workers. The minimum staffing level is one member of staff on duty for three people. In addition to this the Registered Manager is on duty during the day. One member of staff sleeps in overnight. The Registered Manager has NVQ Level 4 and three staff have NVQ Level 2. One member of staff commenced NVQ Level 2 in July 2009. We were given a copy of the Training Development Plan for 2009. We could see that staff had received the required mandatory training in health and safety matters such as fire training, first aid, food hygiene, infection control, health and safety and manual handling. Three staff have Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: received training in Dementia Care, and two in toe nail care.. All staff have attended training in Safeguarding Adults and Medication. A supervision check sheet is used to record staff one to one supervision dates. We were given a copy of this and were able to see that staff had regular supervision, We looked at the personnel file of one member of staff who had recently joined the staff team,. We were able to see that the required recruitment documentation was on file such as application form, references, and Criminal Records Bureau Check. Skills for Care Induction training had taken place. Care Homes for Adults (18-65 years) Page 20 of 25 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 has the qualifications and experience to manage the home. Quality standards are monitored. However, we recommend a formal Quality Assurance System be introduced. Overall there are good systems in place for the management of health & safety. Evidence: The Registered Manager is also one of the Registered Providers. She has obtained NVQ level 4 and attends periodic training to ensure she maintains the skills and knowledge needed to manage the home. The Registered Manager works full time in the home and is able to monitor care in the home. She had completed the Annual Quality Assurance Assessment and had identified how the standards required are being met and highlighted areas for improvement. We did not ask to sample feedback questionnaires from people and their families on this occasion. No formal Quality Assurance monitoring tool is in place. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: We recommended that the Registered Manager develops a format for monitoring and recording the quality of care on a periodic basis. We looked at sample of health and safety documents kept in the home and information given in the (AQAA). We examined risk assessments and could see assessments had been completed for the home and staff activities. A premises fire risk assessment had been completed in 2009. The fire protection system and a gas safety service had been carried out in 2009. Electric testing equipment testing had taken place in 2008. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 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 6 20 We recommend that the files for peoples care records be updated and streamlined We recommend that additional information be inserted with regard to the medical records of one person to improve the guidance on this medication. We recommend that the Registered Manager look at ways to improve the ambiance of the home particularly the living room/dining room. We recommend that a format be developed for use as a Quality Assurance monitoring tool. 3 24 4 43 Care Homes for Adults (18-65 years) Page 24 of 25 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!