Care Home: Kingsway, 83a

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What the care home does well The home is small and the majority of people living at Kingsway have done so for a number of years. There is a very homely atmosphere throughout. Staff are aware of people`s needs and review their practice and the way in which they work with people. What has improved since the last inspection? A new Manager has been registered since the last inspection in 2007. This had been a concern at previous inspections particularly in 2007, as the home had been without a Manager and firm leadership. This is now in place and the new Manager was able to demonstrate proficiency during the registration process and during this inspection. Life Opportunities Trust have been reviewing the documents provided for people who use the service and these have been improved and made more user friendly. A new staff Induction Pack has also been produced and is ready to be used. The recording and reviewing of care records has improved since the last inspection. What the care home could do better: We have not made any Statutory Requirements as a result of this inspection visit. We have made one recommendation for Service Manager Regulation 26 reports to be forwarded to the home on completion. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kingsway, 83a Kingsway, 83a Hayes Middlesex UB3 2TX     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: Susan Woolnough-Singh     Date: 1 1 0 2 2 0 1 0 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Kingsway, 83a Kingsway, 83a Hayes Middlesex UB3 2TX 02088137828 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): kingsway@lifeopportunitiestrust.co.uk Life Opportunities Trust Name of registered manager (if applicable) Miss Kelly Louise Saint Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 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 Date of last inspection Brief description of the care home 83a Kingsway provides accommodation and personal care for adults each with learning disabilities. The home is registered for four placements. The home is a detached house in a residential area of Hayes. It is close to local amenities and transport links. Shepherds Bush Housing Association owns the building and the organisation Life Opportunities Trust (LOT) provides the care. The environment is homely and comfortable. There is a front and rear garden. The front garden has grass and flowerbeds and the rear garden is mainly laid to lawn. There is a small patio area. The home aims to provide a range of high quality services for people for learning Care Homes for Adults (18-65 years) Page 4 of 28 care home 4 Over 65 0 4 Brief description of the care home disabilities, which reflect and respect their individuality and wishes. The home seeks to promote active participation in the local community. Care Homes for Adults (18-65 years) Page 5 of 28 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: We visited the home on the 16th and 22nd December 2009. The second visit was to meet with the new Registered Manager. We met care staff who were on duty and two people who live at the home. All of the National Minimum Standards for Younger Adults were assessed. We toured the building, looked at peoples care records and staff recruitment records. We also sampled a small number of records pertaining to Health and Safety. The home completed an Annual Quality Assurance Assessment (AQAA) in September 2009. This sets out how the National Minimum Standards are being met and identifies strengths and further areas for improvement. The (AQAA) also includes details and Care Homes for Adults (18-65 years) Page 6 of 28 statistics in relation to the home. We have used some of this information in completing this report. We spoke with two people living at the home as well as sending questionnaires. We also sent out questionnaires to relatives and staff. The home was rated as an Adequate Service in 2007. This rating has changed to a Good Service as a result of this inspection and assessment of the National Minimum Standards. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. 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 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care 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 9 of 28 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 and their families have the information they need about the home prior to moving in. The home makes the necessary arrangements for people to have their care needs assessed and to visit the home prior to moving in to the Kingsway. Evidence: A Statement of Purpose and Service Users Guide have been produced for the Kingsway. The written information in the Statement of Purpose is clear and is accompanied by pictures. We looked at the Statement of Purpose with a person who lives at the home. He/she said its about the Kingsway and named the staff in the photograph section on staffing. Information on the home is also on display in the entrance hall; on display is the Service Users Guide, previous Inspection Report and Procedures. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: A full assessment is given prior to people moving into the home, this is completed by the Local Authority Social Services Team and is in conjuction with the person and their family. Trial visits and overnight stays can be arranged before people move into the Kingsway. Care Homes for Adults (18-65 years) Page 11 of 28 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. Care plans are in place for each person who uses the service; these generally give a clear picture of their needs. People who use the service are encouraged to make daily choices although guidance is given where necessary. Risk assessments have been carried out, thus identifying and minimising risks to service users. Evidence: We looked at the care plans of two people who live at the home. These contained the required information and guidance for supporting people in their personal care and daily living. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The care plan sets out the areas people need help with and areas where they are encouraged to be more independent. The care plan is descriptive and covers all the headings required in the National Minimum Standards for Younger Adults. At the last inspection we required that the care of one person be reviewed. We discussed this with the Registered Manager as part of this assessment and heard that this had been complied with, and detail was given as to the referrals made and professional support being received by the home. Risk assessments had been completed which enabled people to have a degree of independence for example in managing their own money and risks to personal safety. Care Homes for Adults (18-65 years) Page 13 of 28 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 who use the service have the opportunity to participate in day services and activities in the community. Peoples independence is encouraged within their ability, and family links are good. The menu provides a varied and balanced diet and peoples preferences are considered. Evidence: We sent out and received four surveys to people who live at the home. People responded positively to questions about the home, staff, and decision making. One person made additional comments with the help of staff. He/she commented that the home looks after all my needs. An improvement was identified as a walk in shower room. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Two relatives/carers returned surveys. Respondents indicated that they are satisfied with the home and the level of care. One person commented that the home and staff are caring and look after residents very well. The respondent felt that people could go out more, when asked what the service could do better. On the first day of the inspection two people were at home. We met both of them and spoke mainly to one person about life in the home, we also met and spoke briefly to one relative, who indicated that he/she was satisfied with the home. On the day of the inspection one person was going out for a Christmas Trip to a local Theatre. We noted that the lounge had been prepared for Christmas with a Christmas tree and presents for all. People at the home attend a Day Service during the week. We spoke with one person about his/her daily schedule and activities who said that he/she went to a Club two evenings a week and to the Day Centre twice a week. Going out for a meal with staff was mentioned and doing house work and laundry with staff. We looked at the day and activity programme for another person, this included three days at a day centre, going out with staff and family visits. A key worker is designated for each person who will liaise with the persons family. A repeat rolling menu is in place, and the presentation of this had been improved since the last inspection. The menu is are produced with photographs and has been laminated, and there is a picture menu for each day of the week. The lunch usually consists of sandwiches/salad and fruit and evening meals a variety of dishes such as pasta, fish, curry and vegetables. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and health care 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 are encouraged to look after their own personal care and assistance is given when required. Peoples health care needs are identified and monitored. A procedure is in place to ensure the safe administration of medication to people who use the service. Evidence: We looked at health and personal care documents in the two care plans that we examined. Health Action plans were completed for each person, the information recorded in these is good and contains detailed information on how personal care is to be provided as well as support needed to look after oral hygiene and skin and feet, for example. The (AQAA) informed us that some work is being done, with the use of DVD s to support people in improving their self care. The Health Action Plan is produced in pictorial format. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The home has identified areas for improvements in that care plans could be easier for people who use the service to read and using a pictorial format has been considered. We were able to see an up to date record of visits made to health care professionals such as dentist, General Practitioner and Optician. Life Opportunities Trust has policies and procedures for staff on the storage and administration of medication. The Inspector viewed the medication records. The prescription medications are provided by the Pharmacy in a monitored dosage system, this has been introduced since the last inspection. The medication administration record charts were fully completed, with administration of medication signed for. The (AQAA) informed us that the General Practitioner had reviewed peoples medication and one person had moved to an alternative GP for their care. We confirmed with the Registered Manager after the inspection visit that all staff had received training in the safe administration of medication. This training is carried out at the home and is part of the induction training prpgramme. New staff are only permitted to administer medication once assessed as competent. Care Homes for Adults (18-65 years) Page 17 of 28 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. Procedures for complaints and for adult protection are in place. Staff had received training in the Safeguarding of Vulnerable Adults. Evidence: The home has a policy in place for Safeguarding Adults and Prevention of Abuse. A Complaints Procedure is also available for people who use the service. We looked at the complaints/safeguarding procedure for people who use the service. This had been updated and improved since the last inspection. Types of abuse are depicted in sketches with plain English, the second section of the procedure is titled What should I do, this gives the steps for reporting poor practice and allegations of abuse with information on different external organisations that can contacted. Staff had attend London Borough of Hillingdon Safeguarding of Vulnerable Adults training, in 2008. We looked at the procedures and examples of systems in place for managing peoples personal finance. We discussed with the Registered Manager the different types of transaction that take place between (LOT) and the London Borough of Hillingdon and support given to people to manage some element of their own finances,depending on their ability to do so. Where staff support people a record of all transactions is made. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 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 home is well maintained and provides homely and comfortable accommodation for people who use the service. Evidence: The home is a detached property with four bedrooms and a sleeping in room/office. The furnishings and decor are of a good standard and overall the environment presents as being pleasant and homely. On both visits to the home the home was warm and comfortable. There is a spacious communal dining/sitting room. There is a table and six chairs in the dining section, and two sofas and a comfortable chair plus television, DVD, video and music players in the lounge section of the room. The kitchen is spacious enough for those who may wish to help with food preparation. A bath and a shower are provided. There are two toilets and each bedroom has a wash hand basin. The home was clean and tidy throughout. There is a laundry room with a washing Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: machine and tumble dryer. An Occupational Therapist has assessed one of the bathrooms since the last inspection and a shower chair has been provided. The Registered Manager has requested redecoration of some parts of the interior, from the Housing Association. Care Homes for Adults (18-65 years) Page 21 of 28 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. Recruitment procedures are in place to ensure suitable people are recruited as care workers. The home was appropriately staffed to meet the needs of the people who use the service. Training is scheduled to provide staff with the skills they require. Evidence: We looked at the recruitment file of a member of staff who had recently been appointed to examine recruitment procedures and records. A recruitment checklist had been completed with a record of the Criminal Records Bureau disclosure number. Two references had been sought, one from the last employer. Identity verification was available and an Employment Contract. New employees are subject to a number of probationary reviews ending after a nine month period. The new member of staff had started the induction training. Three staff have completed National Vocational Training Level 2 with one member of staff staring training in June 2009. We received a copy of the training schedule, Staff had received training in moving and handling, fire safety, first aid, protection of vulnerable adults and food hygiene. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: A new Induction Training Pack had recently been developed by a working group of Life Opportunities Trust staff. We received a copy this, the aim is to introduce this to new staff in January 2010. The pack has been well put together and provides a very good induction into care for staff new to the home and possibly care work. It includes information on understanding the organisation, information and a check list on working in the home and policies and procedures. Health and safety and working with vulnerable adults is also included. There are questionnaires to assess staff learning and all sections of the induction book are to be signed when completed by the care worker and supervisor. We received three completed surveys from staff. Two staff commented on the service. Staff felt that the home recognizes peoples different capacity and people are encouraged to maintain their independence. One person commented that they receive regular supervision, and training is up to date. During the night one member of staff is on duty and sleeps at the home. It was highlighted that that it is sometimes difficult the next day, on the morning shift if the night has been disturbed. At the time of the inspection the staff team consisted of three permanent members of staff and one Bank staff member who is employed by Life Opportunities Trust, one vacancy existed. The minimum number of staff on duty is one member of staff during waking hours and one member of staff sleeping in, overnight. Care Homes for Adults (18-65 years) Page 23 of 28 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 Manager has the knowledge and the skill to manage and administer the home in a professional manner. Systems are in place for monitoring standards and quality. Health and safety in the home is assessed and monitored for the safety of people who use the service. Evidence: The Registered Manager has been employed by Life Opportunities Trust for approximately six years, with two years as a Deputy Manager of a care home and Supported Living Scheme. She has an NVQ Level 3 and NVQ Assessors Award. The Registered Manager had completed the Annual Quality Assurance Assessment as requested. This demonstrated that the National Minimum standards for younger Adults had been reviewed by the home and information was given on how these were being Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: met and any improvements to be made. A format for in house quality assurance monitoring had been recently produced. We received a copy of this format which covered the information to be checked and updated in care plans and health action plans, general day to day systems used in the home, complaints and record keeping. A Service Manager from Life Opportunities Trust visits the home and completes a monthly Regulation 26 Report. The last record of this was February 2009. We were informed that these do take place monthly but the reports had not been forwarded to the home. We recommend that these be forwarded shortly after the visit so that they can be kept in the home and used as part of quality assurance and planning. The AQAA informed us that policies and procedures are in place for the health and safety of people who use the service and staff. These are listed and include fire safety emergency procedures and infection control. We looked at a sample of health and safety records. A fire safety risk assessment had been completed for the home and different areas in the home, in 2009. Further information was recorded in a fire safety log book. Fire alarm checks/drills had taken place regularly, the fire system had been serviced in September 2009 and the fire extinguishers in December 2009. We were able to see that risk assessments were in place in regard to activities in the home. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 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 39 Regulation 26 reports carried out by a Service Manager should be forwarded to the home on completion. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) 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 28 of 28 - 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!