Care Home: Greenford House

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Greenford House 38 Greenford Road Harrow Middlesex HA1 3QH 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: THOMAS McKERVEY Date: 1 7 0 2 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 Inspection report CSCI Page 2 of 27 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Greenford House 38 Greenford Road Harrow Middlesex HA1 3QH 02088640626 02088640626 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Monpekson Care Limited Name of registered manager (if applicable) Mrs Pek Kio Entwistle Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: 3 LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 27 A bit about the care home 38 Greenford Road is a private care home owned by Monpekson Care Ltd, a small, local care organization. The service at the home provides care and accommodation for up to three adults with learning disabilities. There was one vacancy at the time of the inspection. This is sometimes used to provide respite care. The home has been open since 1997. The house is semi-detached on two floors. It is situated on a busy main road close to local shops and transport. There are three single bedrooms and a bathroom on the first floor. There is a large lounge and dining room on the ground floor. There is a small rear garden with a lawn and patio. There is parking for two cars to the front of the building. The fees for the service are £1245 per week. Care Homes for Adults (18-65 years) Page 5 of 27 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 Care Homes for Adults (18-65 years) Page 6 of 27 How we did our inspection: This is what the inspector did when they were at the care home This key inspection was unannounced. The inspection was completed in three hours. The manager was present throughout the inspection period and a member of staff arrived for duty later in the afternoon. One resident was present during the whole inspection. The other resident returned from a day centre later in the day. The manager, staff and two residents were all spoken to, and all areas of the home were visited, including bedrooms with the residents permission. As part of the inspection process, we looked at the AQAA which was sent to us by the manager. This document is a selfassessment and it provides information about the service and who lives and works in the home. The AQAA is also used to assess what the service does well and how it intends to improve where necessary. Reference is made to this document in various sections of this report. Prior to the inspection, we sent out surveys to staff and residents. Three responses were received from three staff but none from the residents. Residents and staffs files and other records pertaining to the running of the home were also examined as part of the inspection process. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well What has got better from the last inspection Residents now sign their care plans as evidence that they are fully involved in compiling these and risk assessments now cover all potential hazards to safeguard residents from harm. Improvements have been made in accounting for all Care Homes for Adults (18-65 years) Page 8 of 27 medication that is sent from the pharmacy. This aids proper auditing and stock control, and all staff have been trained in the administration of medicines. Four staff have now attained NVQs at level 2 which enables them to be more competent in supporting residents. They have also attended training in first aid so that they can deal more effectively with any medical emergencies. 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 Care Homes for Adults (18-65 years) Page 9 of 27 If you want to speak to the inspector please contact THOMAS McKERVEY 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 Care Homes for Adults (18-65 years) Page 10 of 27 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 11 of 27 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 . People who are considering moving in to this home can be confident that they will have a thorough assessment of their nees and that the home will meet these completely. Residents can be assured that their placement in the home will be regularly reviewed to ensure that the service is still appropriate for them. Evidence: No new residents have been admitted to the home since the last inspection. One person who used to live in the home was discharged to another home that was more appropriate to meet their needs. This has resulted in a vacancy. There was evidence in the case files that the local authority carries out annual reviews of the placement. These concluded that the home was continuing to meet these residents needs. The records of the revues showed that residents relatives are invited to attend reviews and are able to comment on the service provided. The homes policy and procedures give prospective residents the opportunity to test drive the home before moving in. Care Homes for Adults (18-65 years) Page 12 of 27 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 . Residents can be confident that they will have a say in their care plans and that the home will consult with them and support them in their choices about their daily lives. Evidence: Each resident has an individual care plan, both of which were examined in detail. The care plans include information about the persons lifestyle, history and leisure interests. There were also assessments regarding the persons daily living skills and ability to manage personal finance. The care plans were signed by the residents, which indicates that they are aware and are involved in what is written about them. The care plans are reviewed six monthly and annual care reviews are held by the care manager from the local authority to ensure that the residents needs can still be met by the home. Both residents have an allocated key worker who takes particular responsibility for them and updating the care plan. Both residents were able to name their key worker. Both residents are articulate and in discussion with them, we were satisfied that they had a wide range of choice about their lives, including the time of going to bed and getting up and what activities they wish to take part in. The homes House Meetings book demonstrates that monthly meetings are held with the residents and their decisions Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: are recorded and acted on. Risk assessments were documented to guide staff about activities that take place in the home and the community. This ensures that reasonable risks are taken to ensure that the residents are enabled to live as full lives as possible. Care Homes for Adults (18-65 years) Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The residents can be confident that they have an excellent lifestyle while living in the home. They have a full say in how they wish to live and what activities they wish to take part in. The meals provided are nutritious and in accordance with the residents wishes. Evidence: Both residents have access to leisure resources in the community. The residents told us that staff took them shopping, to restaurants, cinema, bingo, coach trips and to the hairdressers. At the time of the inspection, one person was at home and the other resident was at a day centre, returning about 3pm. Both people attend day centres and colleges on various days during the week. One resident uses public transport with a bus pass. The residents are supported to do their own laundry and clean their rooms. The manager informed us that the residents link up with another of the companys Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: homes every fortnight for social evenings of games and karaoke sessions. Activities were recorded in daily report books. Both residents had a holiday last year, one person going on a cruise. The residents stated they were very happy living in the home and that the staff were very good to them. The residents have keys to the front door and to their rooms. They have close ties with their relatives who visit the home frequently. Records of these visits are in the visitors book.One of the residents has a boyfriend whom she visits often. We observed that there was a warm and caring relationship between the residents, the manager and the staff who were present during the inspection. It was evident from observation, discussion with the residents and looking at their records, that they enjoy a lifestyle that they and their relatives greatly appreciate. Their care is tailored to their individual needs in accordance with their wishes. The menu was quite varied and well balanced and there was fresh fruit available. There was an ample supply of food in the cupboards and fridge/freezer. Food was appropriately labelled and dated. The residents said that they had snacks and hot and cold drinks whenever they liked. The residents said they were able to choose their meals and liked to go food shopping with staff. In a staff survey, one staff said that the service does well in making sure that the service users have a very good social life in the area. Another staff commented that the service users are consulted about their views and always come first. Care Homes for Adults (18-65 years) Page 16 of 27 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 . Residents receive personal care and support in a way they prefer. The staff take care to make sure that residents are supported by healthcare professionals and their medication is administered safely. Evidence: Each person has a health action plan that details their medical history and any allergies. The case files contain appointments with a range of healthcare professionals, for example, the GP, chiropodist and dentist. One of the residents had an accident last year, resulting in a fracture. However, at the time of this inspection, both residents were reported as in good health and they appeared well cared for. Both residents had been given the flu jab in the winter. The staff use a body map chart to record any accidents. There was evidence in the case files that residents had been seen by the consultant psychiatrist and their medication had been reviewed. Both people are quite independent regarding their personal care, but one person said the staff help her to get in and out of the bath. This resident said that staff support them in a dignified and discreet manner. There were monthly records of the residents weights. The residents Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: have keys to their bedrooms to ensure privacy. One person told us that they always lock their door when they go out. Medication records were examined. These showed that staff always sign when for the administration of medicines and there was a book for recording any medication that was returned to the pharmacy. The manager was advised to record on the administration sheet, the number of tablets supplied each month from the pharmacy as a good way to audit medication stocks. This was complied with at the inspection. Care Homes for Adults (18-65 years) Page 18 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents can be confident that if they have any concerns about the service, they will be taken seriously. The staff are aware of what to look for regarding suspected abuse, but residents may not be fully protected by staff who do not understand how to report incidents of abuse to outside agencies. Evidence: The home has a book for recording any complaints, which showed that none had been made for a long time. The residents said that they loved living in the home and were well cared for. They said they could talk to the staff if they had any concerns. There was a copy of the local authority adult protection procedure in the home. We noted that staff had attended training on this subject. In discussion with a member of staff during the inspection, it was clear that they understood the various types of abuse that could occur and stated that they would report any incidents of abuse to the manager immediately. However, this person was not very knowledgeable about the procedure for reporting abuse to outside agencies such as the local authority, the Commission or police. A requirement is made for all staff to be made aware of the Whistle-blowing procedure. Care Homes for Adults (18-65 years) Page 19 of 27 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 residents can be confident that the home they live in is comfortably furnished and attracitive and provides a homely environment. Evidence: The residents bedrooms were visited. They were personalised to individual taste and were fully furnished. Each bedroom is of single occupancy and has a washbasin fitted. Personal effects were in evidence, including family photographs, personal televisions and music centres. Communal areas include a large lounge and dining room. These were also well furnished and provided an attractive enviornment to relax and eat. There is a large television in the lounge for residents use. There is a downstairs toilet and a bathroom and toilet upstairs. There is a device to enable a resident who has mobility difficulties to get in an outof the bath with staff support. The kitchen contained appropriate equipment that was in good condition, and all areas of the home were clean, tidy and smelled fresh. There is a large attractive gardent at the rear of the property which was well maintained. Care Homes for Adults (18-65 years) Page 20 of 27 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 . Residents can be confident that there are sufficient numbers of staff on duty to support them. The staff are well trained and competent to meet the residents needs. Evidence: No new staff have been employed since the last inspection, so Standard 34 was not assessed. This group of staff have been together for a long time. This provides good continuity of care and fosters good relationships. Both residents expressed praise for the staff who they described as being very caring nad friendly. In an interview with a staff member, they displayed a good knowledge of the residents and how they liked to be supported. The staffing levels are one person on duty during the day and one staff sleeps in at night. This is adequate for the current residents. The manager stated that two staff are on duty when the respite service user is in the home. Staff training records showed that they had attended training on health and safety, food hygiene, medidcation and first aid. Certificates of attendance for some of the training were not availalbe in staff records. However, a member of staff who was spoken to, confirmed that they had attended appropriate training courses. A requirement is made for certificates of attendance to be available for inspection as further evidence of training. In the AQAA, the manager states that four staff have attained NVQ level 2. Staff confirmed they received regular supervision and examination of staff records Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: indicate that supervision is given regularly. Staff meetings are held monthly. Examination of the staff meeting minutes recorded that they included an overview of residents condition and informing staff about matters pertainig to the runnning of the home. There were records to show that regular staff supervision takes place, and the member of staff who was spoken to, described supervision as a positive experience that enables them to talk about their job and identify training needs. Care Homes for Adults (18-65 years) Page 22 of 27 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 residents can be confident that the manager runs the home in a way that takes into consideration their views and wishes. There are good accounting systems in place to ensure that residents finances are safeguarded and that the home is a safe place to live. Evidence: The manager is registered with the Commission for Social Care Inspection and has many years of experience of working with people with a learning disability. She also holds the NVQ level 4 in care. The residents who were spoken to, said the manager was approachable and was always available to talk to. We observed that there was an open and friendly relationship between the manager, staff and residents. A quality assurance questionnaire had been carried out, which showed that residents and their representatives had been consulted about the quality of the service. Regular meetings are held with the residents, which are documented. These meetings afford residents with an opportunity to have a say in how the home is run. We checked the records of residents finances that are held on their behalf. These indicated that proper accounting of income and outgoings takes place, with receipts Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: being kept for all purchases. The servicing records were randomly checked. There is a fire risk assessment in place for the home. Servicing of the gas, fire and electrical systems had been carried out in the past year. Weekly fire alarm tests were documented. Portable electirical appliances were also tested and there was a vaild employers certificate of insurance in place. Care Homes for Adults (18-65 years) Page 24 of 27 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 Care Homes for Adults (18-65 years) Page 25 of 27 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 23 21 The manager must ensure that all staff are aware of how to raise concerns if abuse is suspected. 10/03/2009 This is to ensure that residents are properly safeguarded from harm. 2 35 18 Certificates of attendance at staff trainiing courses must be availalbe for inspection. 31/03/2009 To provide evidence that staff have attended training that is appropriate to residents needs. 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 26 of 27 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!