Care Home: Minford Gardens, 35

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What the care home does well Residents are encouraged to involve themselves in the daily life of the home. Residents get good support to exercise choice and make decisions about their lives. Residents are supported to be a part of their local community and to keep in touch with their friends and families. Residents are encouraged to take part in a range of activities. The home`s menu is varied and promotes healthy eating. Residents are able to choose what they would like to see on the menu. Residents receive good care and see healthcare professionals when they need to. Medication is stored and administered safely. The house is clean, homely and well decorated. What has improved since the last inspection? The introduction of a new management team has improved the service provided to residents and the support available to staff. Residents are more involved in the life of the home and are doing more for themselves. Residents have been supported to exercise choice and make decisions about their lives. Residents have more opportunities to go out and to be part of their local community. Residents have been supported to try new activities. Recent healthcare interventions have resulted in improvements to residents` quality of life. The appearance of the house and garden has improved. What the care home could do better: Review risk assessments where necessary. Repair or replace the flooring on the stairs where this has split. Install safety glass in the door between the kitchen and the dining room. Provide evidence that the fire alarm system has been serviced by a suitably qualified person.Obtain a current Electrical Installation Certificate. Provide evidence that electrical appliances are safe for use. Check residents` monies more often. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Minford Gardens, 35 Minford Gardens 35 Minford Gardens West Kensington London W14 0AP     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: Simon Smith     Date: 1 6 0 7 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. 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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.cqc.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: Minford Gardens, 35 35 Minford Gardens Minford Gardens West Kensington London W14 0AP 02076038768 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : gill.ritchie@yarrowhousing.org.uk Yarrow Housing care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 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 35 Minford Gardens is a registered care home providing personal care and accommodation for four people with a learning disability. At the time of this inspection four men were living in the home and there were no vacancies. Notting Hill Housing Trust owns the property and the care is provided by Yarrow Housing Limited, a voluntary organisation. The home is close to the shops and transport links of Shepherds? Bush and Hammersmith. The home is well staffed to support residents to take part in activities in the home and the community. Care Homes for Adults (18-65 years) Page 4 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 peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We used information from a range of sources when making this judgement about the home. This included visiting the home unannounced on 17th June 2009 and speaking to people who live there, the manager, deputy manager and staff. We checked some written records including residents files and health and safety checks. We also took into account any information the home had sent us since the last inspection. This included notifications of any accidents, incidents, complaints or safeguarding alerts. Care Homes for Adults (18-65 years) Page 5 of 27 The manager filled in a Quality Assurance Assessment (AQAA) which gave us information about the home in the last year. Three staff who work at the home completed surveys about the quality of the service. Their comments are included later in this report. What the care home does well: What has improved since the last inspection? What they could do better: Review risk assessments where necessary. Repair or replace the flooring on the stairs where this has split. Install safety glass in the door between the kitchen and the dining room. Provide evidence that the fire alarm system has been serviced by a suitably qualified person. Care Homes for Adults (18-65 years) Page 7 of 27 Obtain a current Electrical Installation Certificate. Provide evidence that electrical appliances are safe for use. Check residents monies more often. 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 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 9 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. There is clear information about the home and the service it provides. Residents rights are set out in a written agreement. Evidence: The home has a Statement of Purpose, which gives details of the services and facilities provided. A service user guide has been produced for residents. This was reviewed and updated in February 2009. Residents needs were assessed when they moved into the home and have been reviewed since then. Residents have a written agreement for their accommodation which was reviewed in February 2009. This agreement outlines their rights and responsibilities as tenants. Care Homes for Adults (18-65 years) Page 10 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 are encouraged to involve themselves in the daily life of the home. Residents get good support to exercise choice and make decisions about their lives. Risk assessments need to be reviewed to make sure they reflect current needs. Evidence: Each resident has a written care and support plan. The plans we checked contained good information about residents needs and guidelines on giving personal care and support. The manager said that staff were in the process of updating residents person centred plans to reflect their current needs. Since the last inspection staff have focused on involving residents in the life of the home and supporting residents to do more for themselves such as cleaning their rooms and managing their laundry. Staff have also encouraged residents to learn new Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: skills, for example by using public transport instead of taxis, and to be more independent in terms of their personal care. Residents have also been supported to make decisions about issues that affect them. For example one resident has been involved in the recruitment of new staff and it is hoped to involve other residents in this process. The manager said that one resident has an independent advocate. The home has focused on improving the staff teams understanding of residents communication needs. For example one resident uses Makaton to communicate but staff did not have these skills. Some staff have attended Makaton training recently and others are to attend in the near future. The manager said that referrals have been made to the local community team for people with learning disabilities to seek their input in improving residents ability to communicate effectively. There are a number of risk assessments in place to support residents in living an independent lifestyle but some of those we checked needed review. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to be a part of their local community and to keep in touch with their friends and families. Residents are encouraged to take part in a range of activities. The homes menu is varied and promotes healthy eating. Residents are able to choose what they would like to see on the menu. Evidence: No residents currently attend formal day services but residents are being encouraged to try new activities to find out what they enjoy. Once staff have established which activities residents enjoy they will work with them to develop a more structured Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: programme of activities that suits their individual needs and preferences. The manager said that residents had few opportunities to go out in the evenings in the past, partly due to the homes shift pattern. Residents are now encouraged to go out in the evenings and were planning to attend an evening event on the day of inspection. There was evidence that residents make regular use of their local community, visiting shops, cafes and other community resources. Residents are also supported to keep in touch with their friends and families. Staff said that two residents families visit regularly. Some residents have expressed a wish to contact relatives they have not seen for some time. The manager said that staff are supporting residents to make contact with these relatives. The homes menu is varied and promotes healthy eating. The manager said that the menu is planned weekly and that residents are more involved in choosing what appears on the menu than they were in the past. Care staff prepare and serve food, which is appropriate given the size of the home. All staff attend food hygiene training as part of their induction programme. The manager said that residents help with food shopping and are encouraged to get involved in preparing meals with staff support. Care Homes for Adults (18-65 years) Page 14 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 good care and see healthcare professionals when they need to. Recent healthcare interventions have resulted in improvements to residents quality of life. Medication is stored and administered safely. Evidence: The inspection provided evidence that residents receive good care and see healthcare professionals when they need to. The home has focused on assessing residents healthcare needs in recent months and this has resulted in a number of benefits for residents. For example one resident had a cataract operation which greatly improved his sight. Another resident had his medication reduced following a medication review, which has been beneficial to his quality of life. The manager said that all residents had been supported to attend a general health check in the last six months and that all medication had been reviewed. Medication is Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: stored securely in the home and there is a written medication policy. All staff have training before giving medication. We checked medication administration records for all residents. These contained no omissions or errors. Care Homes for Adults (18-65 years) Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an appropriate Complaints procedure. Staff are trained to recognise and report abuse. Evidence: Yarrow Housing has an appropriate Complaints procedure, a copy of which is on file at the home. Yarrow Housing also has a whistle-blowing procedure which enables staff to report any concerns they have about poor practice. The homes Quality Assurance assessment told us that there have been no complaints about the home or safeguarding referrals in the last year. The service works within the Joint Policy on Suspected Abuse of Vulnerable Adults, which provides guidance for staff in the recognition and reporting of abuse. Training is also provided for staff in the protection of vulnerable adults (POVA). Care Homes for Adults (18-65 years) Page 17 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 location of the home means that residents have easy access to local community facilities. The house is clean, homely and well decorated. Evidence: The home is on a quiet residential street close to the shops, restaurants and transport links of Shepherds Bush. The house has a lounge, separate dining room, kitchen and utility room. Each resident has a single room with a basin. Residents are encouraged to personalise their rooms and the bedrooms seen contained evidence of individual interests and hobbies. The appearance of the home was much improved since the last inspection. The house has been redecorated and new flooring and blinds have been installed. The garden is now an attractive and inviting space to spend time in. The communal bathroom is much smarter following the redecoration. All parts of the home were clean and tidy. Whilst these developments are very positive there are some areas in which further improvements could be made. The kitchen units are worn in some areas and would Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: benefit from replacement in the near future. The kitchen roof is plastic and staff said that this makes the room uncomfortably hot in warm weather. Some of the new flooring material on the stairs is splitting. The last inspection report required Yarrow Housing to install safety glass in the sliding door between the kitchen and the dining room. A clear film has been placed on the glass but safety glass has not been installed. Care Homes for Adults (18-65 years) Page 19 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. Having a number of staff vacancies has put pressure on the staff team but the manager is actively recruiting to the vacant posts. Yarrow Housing carries out appropriate checks on new staff. The support and training available to staff has improved. Evidence: The full staff complement is nine but four of these posts were vacant at the time of inspection. The manager said that she had interviewed some prospective staff just before the inspection and had more interviews planned. The manager said that the home has access to two members of bank staff and regular agency staff to cover vacancies. All staff have to supply two references and proof of identity when they start work. Yarrow Housing obtains a Criminal Records Bureau disclosure for all new staff. We saw evidence of Criminal Records Bureau disclosures for staff at the home. Other staff records are kept at Yarrow Housing head office. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: The manager has improved the support available to staff since the last inspection. Staff who returned surveys said that they get regular supervision and support from the manager. Staff have also attended training in areas that are relevant to residents needs. Care Homes for Adults (18-65 years) Page 21 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 introduction of a new management team has improved the service provided to residents and the support available to staff. The service is regularly monitored for quality and residents have opportunities to contribute their views about the service. Standards of health and safety were good but the home must obtain some important safety certificates. Evidence: The manager and deputy manager started work at the home in November 2008 having worked together at another Yarrow Housing service previously. Prior to this there had been frequent changes in the homes management which had affected the service provided to residents and the support available to staff. The manager and deputy form a strong management team and this has improved the quality of the service. The manager must apply for registration with the CQC. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: Comments made by staff who returned surveys highlighted some of the improvements achieved since the new management team arrived. These comments included, The new manager has brought a new outlook. We are implementing new systems to benefit service users and staff and We are supporting service users to become more independent. We are working together as a team. The service is regularly monitored for quality in a number of ways. A Yarrow Housing manager carries out monthly quality assurance visits. The placing authority carries out regular monitoring visits, one of which took place on the day of inspection. Staff support regular residents meetings and record residents views and choices. The manager said that the home also seeks the input of residents families. Two residents have bank accounts and two residents have building society accounts. The manager said that Yarrow Housing audits residents finances quarterly and that residents monies are checked weekly by staff. It is recommended that residents monies are checked each day so that any discrepancies are identified and investigated without delay. The home has an appropriate fire alarm system. A fire risk assessment of the building has been carried out and there is an emergency plan for use in the case of fire. The fire officer visited in March 2009 and found that the premises complied with fire regulations. There was evidence that staff carry out regular fire drills. The homes fire fighting equipment was inspected by an engineer in April 2009 but the home needs to provide evidence that the fire alarm system has been serviced by a suitably qualified person. The home has Employers Liability Insurance until March 2010. The Gas Safety Record was issued in September 2008 but there was no evidence of an Electrical Installation Certificate or that portable electrical appliances had been tested for safety. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 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 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 1 9 13 Review risk assessments where necessary. The manager must apply for registration with the Care Quality Commission. 25/09/2009 2 37 9 25/09/2009 3 42 13 Provide evidence that 25/09/2009 electrical appliances are safe for use. Obtain a current Electrical Installation Certificate. Provide evidence that the fire alarm system has been serviced by a suitably qualified person. 25/09/2009 4 42 13 5 42 23 25/09/2009 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. Care Homes for Adults (18-65 years) Page 25 of 27 No. Refer to Standard Good Practice Recommendations 1 41 Check residents monies daily. Care Homes for Adults (18-65 years) Page 26 of 27 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. 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