Care Home: Harrow View, 157

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Annual service review Name of Service: Harrow View, 157 The quality rating for this care home is: The rating was made on: three star excellent 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Ram Sooriah Date of this annual service review: 1 5 1 2 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: 157 Harrow View Harrow Middlesex HA1 4SX 02085375392 02085375392 nigel.brookarsh@ntlworld.com Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : learning disability Conditions of registration: Residential Care Providers Ltd Number of places (if applicable): Under 65 Over 65 5 0 The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service 157 Harrow View is a care home providing personal care, and accommodation for up to 5 adults with primarily learning disability care needs. It was first registered in March 2006. The registered owner is Residential Care Providers Ltd. The responsible individual and the registered manager is Mr Nigel Brookarsh. The home is situated in a residential street close to central Harrow, within a few minutes walk from a variety of shops, restaurants, library, banks and other amenities. There are good links to public transport, including buses and trains, close to the home. The property is in keeping with other houses in the area, and consists of four single Annual Service Review Page 2 of 8 There have not been any changes. bedrooms rooms and a self contained flat. Two of the bedrooms are located on the ground floor. The flat has been designed to meet the needs of a resident who requires residential care support, but who does not benefit from communal living. There is parking for 3-4 cars in the grounds of the house. There is an enclosed garden at the rear of the property. The home charges fees according to the assessed needs of each resident. More detailed information is available from the manager. According to the AQAA there were five residents living in the home at the time of its completion. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? This annual service review includes a review of information that the Commission has received about the home since the last Annual Service Review (ASR) on the 25th March 2009. The last key standards inspection took place in October 2007. As per our procedures an excellent service can have a key inspection within 3 years of the last key inspection and at least an ASR every year, depending on our assessment of the service. We reviewed the information that are sent to us about serious occurrences and events that happen in care homes, as the care homes are legally required to do. These are called notifications. The manager of the home completed an Annual Quality Assurance Assessment (AQAA) on the 28th August 2009 that was forwarded to the Commission. The AQAA is a selfassessment tool for the home to use to evaluate how well outcomes for residents are being met. It also gives us some numerical information about the service. There has not been any other regulatory activity by the Commission with the service since the last ASR and we have monitored the service with the information that is received from notifications, from people who use the service or from social and healthcare professionals. We received three completed questionnaires from residents and four from members of staff to get feedback about the service. The feedback has been useful in getting a view of the service. What has this told us about the service? We have received two notifications since the last ASR in March 2009. The notifications were about incidents that happened as a result of the unpredictable behaviour of residents. We discussed the notifications with the manager and we noted that appropriate action was taken in both cases to address the incidents. We understand that risk assessments are also in place to address the risks that arise as a result of the unpredictable nature of the behaviour of a few residents. Residents said in questionnaires that they are treated well by staff and that they are able to make decisions about their daily life and about how they spend their day in the home. One of the recommendations following the last key inspection was to improve residents access to records such as, the service users guide and the complaints procedure, by producing these in other formats such as audio or easy to read formats, according to the individual needs of the residents. The home seemed to have addressed this recommendation as the AQAA states that the home has a comprehensive statement of purpose and service-user guide. The information is in a format suitable to the needs of the residents, using large photographs and clear layouts. Videos can be provided upon request. The complaints procedure has been available in a pictorial and signs format since the previous ASR. The AQAA suggests that the home continues to look at improving the daily of residents and the provision of social and leisure activities. It says we have increased the amount and variety of weekly activities, increased the use of the Weldon Activity Centre and purchased additional computer laptops for daily resident use. It is positive to note the Annual Service Review Page 4 of 8 increased use of IT equipment as a tool for communication to link with the outside world and for learning. The manager had indeed identified in the previous AQAA that the home planned to increase the use of IT equipment in the daily life of the home. He now plans for residents to have their own email address for residents to have another mean of communication with relatives and friends. In the previous AQAA the manager also informed us of the completion of their outbuilding as an additional resource to be used for the provision of social and recreational activities. In this AQAA we learn that the home plans to purchase new furniture and equipment for the recently built activity room in the garden. The involvement of residents and meeting other people in the local community is a feature of the home. The manager tells us in the AQAA that the home maintains social links and joint activities with , the other home that belongs to the provider in Kenton Road. He adds that the home aims at maintaining regular contact with stakeholders, particularly social workers and family/carers. The AQAA tells us that the home has been looking at ways of improving communication with residents who may have a communication impairment to promote their rights, independence and involvement in decision making processes. It says that the home has increased the review of indivualised communication formats to at least six monthly or annually and has also increased the use of photographs and symbol formats to make paperwork user friendly. For example the AQAA mentions that the home has implemented individualised menu plans for each resident including, where needed, picture formats. In promoting residents rights to have a voice the manager says in the AQAA that the home has increased attempts to link with local advocacy agencies and has also sought advocates via local authority social workers. The AQAA shows that there have not been any complaints or safeguarding referrals in the home. Residents questionnaires show that they all know who to talk to if they were unhappy about the service. The AQAA shows that there has been some improvement with the environment. It says that several resident bedrooms have had a make-over/ upgrade, more appropriate flooring fitted to the ground floor bedrooms, new matting to improve cleanliness of home fitted to front hallway, quicker response times for general repairs by local handyman often on the same day and that the home has invested in a new lawn and plants for the garden. There has also been an increase in parking spaces and a new fencing has been erected at rear of the garden to improve the general appearance of this area. The future plan for the home with regards to the environment includes the purchase of new furniture for the flat, the decoration/ upgrading of the first floor bedrooms and the upgrading and decoration of the first floor bathroom. There has not been any change in the management of the home. The manager of the home is also the registered individual for the organisation. He is well qualified and experienced in the care and support of people with learning disabilities and he says that he keeps himself up to date by completing appropriate training. Staffs response to questionnaires shows that they are satisfied with their job and the training that they receive. They believe that they work well as a team to ensure that residents are appropriately cared for and supported while promoting the residents Annual Service Review Page 5 of 8 rights and independence. One member of staff suggests that there should be more staff on duty when needed so that residents can go out more often. The manager confirms in the AQAA that the home has a Quality Assurance procedure that includes audits as well as a satisfaction survey of stakeholders. With regards to the barriers to improvement, the manager says that local authorities have not always been supportive, such as not providing day placements for residents that come outside the borough. In the managers view one local authority has not been prompt to respond to a residents changing care needs and he says that requests for resources often result in a negative response. He also adds that the local authority has not been supportive in providing training that small providers tend to find difficult to arrange such as training epilepsy in and physical intervention. There has also been a shortage of speech and language therapy support for adults in the Local Borough. The other barrier to improvement that the manager mentions is the small increases in fees from funding authorities that according to him is minimal and does not meet the year on year increase in residential costs. The manager says that he tries to overcome some of these barriers by pursuing the care plan process often without input from social workers, seeking alternative resources outside of local borough which can be from the private and voluntary sector, providing their own resources for activities for residents and seeking cost and efficiency savings without reducing the quality of service to residents. The AQAA also reports that the home has been looking at staff supervision, monitoring, development and for staff to improve their practice. The plan for improvement during the next twelve months in this area includes focusing on staff support and training and reviewing the service development plan with the staff team. What are we going to do as a result of this annual service review? According to this AQAA we learn that the home has carried out the improvement that it had planned previously. The AQAA has also identified areas for further improvement. It is therefore able to carry out a self-assessment, monitor the quality of the service that it provides and implements its own action plan. Information in the AQAA, our monitoring of the home and feedback about the service from residents and staff have shown that there has not been a change in the standard of service that has been provided since the last key inspection. We are not going to change our inspection plan and will plan a key inspection by 15th October 2010. However, we can inspect the service at any time if we have concerns about the quality of the service or the safety of people using the service. An inspection could also be brought forward in cases when there has been a change in provider. We would like to thank the manager for completing a comprehensive AQAA and all residents and members of staff for taking the time to send us their completed questionnaires. The information was useful in giving us a view about the service that is provided by the home. Annual Service Review Page 6 of 8 Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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 copy of the findings in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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