Care Home: Money Lane, 1

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What the care home does well Money Lane provides a comfortable home, people indicated they liked living at Money Lane and were able to make the necessary choices to have a certain level of independence in their leisure activities and routines. We were able to observe that people people had an activitiy schedule and had been out, on both days of the inspection, and people were participating in the life of the home. Money Lane is well maintained and offers a homely environment. Peoples bedrooms were personalised and met their needs. What has improved since the last inspection? Work as been carried out by Mencap to improve the area of consultation with people who use the service to look at standards in the home and how people can be best supported in all areas of their lives. The administration of records had improved particularly the filing of recruitment records. What the care home could do better: We did not make any additional requirments as result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Money Lane, 1 Money Lane, 1 West Drayton Middlesex UB7 7NU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Woolnough-Singh     Date: 2 3 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Money Lane, 1 Money Lane, 1 West Drayton Middlesex UB7 7NU 01895430687 01895439522 h309@mencap.org.uk www.mencap.org.uk Royal Mencap Society Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Mary Clinton Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: One named service user can continue to be accommodated over the age of 65 years old, as agreed by the Commission For Social Care Inspection on the 23rd November 2004, whilst the home can meet the needs of all service users. The home must advise the CSCI when the service user no longer resides at the home. Date of last inspection Brief description of the care home Money Lane is a care home registered to provide care for five adults with learning disabilities and mental health needs. The property is owned by New Era Housing Association and managed by MENCAP. The home is located in a quiet residential area of West Drayton close to local shops and transport links. The service users bedrooms are located on the ground and first floor and there are bathroom facilities on both floors. There is a lounge, kitchen and separate dining room on the ground floor and a Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 0 5 5 Brief description of the care home small office/sleeping in room for staff on the first floor. There is a well maintained garden to the rear of the house. The range fees are £249 to £377 per week. Care Homes for Adults (18-65 years) Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection of Money Lane. The purpose of the Inspection was to assess the key standards for younger adults and to follow up the statutory requirements. Two requirements were made at the inspection on 13th July 2007 these had been met. The inspection commenced on 9th July 2009, and a second visit was made to the home on 23rd July 2009 to meet with the Manager. We spoke with four people who use the service and toured the building. Care plans, staff personnel files and health and safety records were examined. Care Homes for Adults (18-65 years) Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 24 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 24 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 are assessed before moving into money Lane. This assessment focuses on ensuring that the facilities and care services provided meets peoples needs. People have a Contract or Terms and Conditions prior to moving into the home. Evidence: One new service user has moved into the home since 2007. Guidance is available with regard to new people moving into the home in the MENCAP Operational Manual. This covers service user selection and assessment, demonstrating assessed needs can be met and guidance on the introductory visits. We were able to see the needs led assessment for this person at the last inspection prior to the moving in date. We were able to see that a Tenancy Agreement for the person was on file dated July 2007. Other people who live in the home have done so for a number of years. Care Homes for Adults (18-65 years) Page 9 of 24 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 and risk assessments are in place to identify the areas of support needed. Staff are committed to involving people in the planning of their care and supporting their independence. Evidence: The care plans of three people were examined. MENCAP has a care plan format, which is used to record all aspects of the care and support that people need. The care plan is written in the first person therefore the person is stating the areas of care they need support with. The care plan contains very good information on communication written in the first person. This guidance states the many different ways of communication through body language and behaviour in addition to verbal language. A number of risk assessments were also seen. Risks of daily living had been identified, these related to community, household and personal safety. Care Homes for Adults (18-65 years) Page 10 of 24 Evidence: People spoken with indicated that they are supported to make their own decisions and are able to make choices on how to spend their time. A new Quality Assurance System and consultation programme has been introduced by MENCAP. This is covered in outcome area 7. Care Homes for Adults (18-65 years) Page 11 of 24 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 are able to make choices, participate in a variety of activities and develop their life skills. Evidence: Each person who lives in the home has a weekly activity schedule and this had just been updated at the time of the inspection. We were given a copy of the new schedule which covers a variety of activities. People attend either a day service or attend college on a sessional basis. Direct payments are also used to enable people to choose activities on a one to one basis with staff. Household tasks carried out with staff are also scheduled in to the timetable. We could see that one person travels independently and that a variety of sessions have been booked such as yoga and sewing. Some people attend specialist clubs in the evening and one person goes to a slimming club. Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: People have differing levels of contact with family and friends depending on their personal circumstances. We spoke to three people who live at Money Lane about life in the home and their activities. We ascertained that people do a variety of things such as cooking, going out shopping with staff, attending weight watchers and yoga classes. One person had not attended day service for a while and was pleased that staff were trying to find him/her a place. People are involved in menu planning, and are encouraged to prepare their own breakfast and lunch, staff prepare the evening meal. We looked at the menus for a two week period and saw that these were varied. Dietary requirements were noted on the menu and covered in peoples care plan. Care Homes for Adults (18-65 years) Page 13 of 24 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. The health and personal care that people receive is based on their individual needs. The home has policies, procedures and guidance for staff on the safe administration of medication. Evidence: We looked at the care plans and health care records of three people who use the service. People have a health action plan and support plan. Information on health care incorporates physical and mental health, and gender related health issues. A record of health care professional appointments had been made. People had had regular visits to general practitioners dentists and other health care professionals such as chiropodists and opticians. A major pharmacy supply medication to the home in blister packs. The Pharmacy also regularly reviews the record keeping and storage of medication. MENCAP have an operational policy in place for the administration of medication. Training in the safe administration of medication is completed as part of the induction Care Homes for Adults (18-65 years) Page 14 of 24 Evidence: programme. We did not examine the medication cabinet and records during this inspection. Care Homes for Adults (18-65 years) Page 15 of 24 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. People are supported and safeguarded by complaints procedure and staff receive training in the protection of vulnerable adults. Evidence: A complaints procedure is available. The information is produced in a small booklett with easy read language and pictures. There is a tear off section for forwarding concerns and complaints and updated contact details for external professionals including CQC. The file for recording complaints was seen; there had been no complaints since the last inspection. People who use the service indicated that they were satisfied with the service at Money Lane. A good practice guide is available for the management of complaints for staff. One concern had been referred to London Borough of Hillingdon Safeguarding Adults Team in 2008. The concern was investigated an found to be unsubstantiated. All staff have completed training in the protection of vulnerable adults. Keeping vulnerable adults safe also features as part of the MENCAP induction training. Care Homes for Adults (18-65 years) Page 16 of 24 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. A clean comfortable and homely environment is provided for people who live at Money Lane. Evidence: The home is comfortable and well maintained; there are two communal areas the lounge and dining room. An outdoor patio area with tables and chairs can also be used. The bedrooms of three people were viewed and these were seen to be personalised and comfortable, We were able to see that peoples personal interests and preferences were reflected in their bedrooms. All parts of the home were seen, including bathrooms and the kitchen. All of these areas were found to meet a high standard of cleanliness. Care Homes for Adults (18-65 years) Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team have the skills, knowledge and expertise to meet the needs of the people living at Money Lane. There are recruitment procedures in place to ensure that people who meet the criteria and statutory requirements are employed to work in the home. Evidence: New staff receive a good induction programme provided by MENCAP. This is completed as part of the new staff probationary period. The induction is completed in a workbook and includes the knowledge and skills required to work in residential care and support people who use the service. At the present time the number of staff who have completed an NVQ in Care is three. Two staff have NVQ level 3 and one has NVQ level 2. Three staff are awaiting their ceritificates for the completion of NVQ training. The staff team consists of the Manager Designate, and seven support workers. MENCAP relief workers are employed to cover vacant posts and shifts. There is a minimum of two members of staff on shift during waking hours. One member of staff Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: sleeps on the premises overnight. There is no waking night staff. Additional staff are employed on a direct payments basis to carry out one to one work with people. We looked the rota for the week 6th July to 12th July. Two staff were rostered on for each shift and five shifts had been covered by relief workers. The personnel files of one member of staff was seen. The required documentation was on file including identity verification, CRB checks and two written references. There was evidence in the files that regular one to one supervision had taken place this had been recorded and covered witha set agenda with a focus on care practice and training. Recruitment files had been reorganized since the last inspection and information was filed well. Care Homes for Adults (18-65 years) Page 19 of 24 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 home is managed and administered in the best interests of people who use the service. An excellent new format for consulting people who use the service has been developed, this has yet to be tried out at Money Lane. Systems are in place for health and safety monitoring of the home. Evidence: Regular staff meetings are now taking place, the previous minutes of these were seen. The agenda is focused on household issues and the care of people who use the service. A new way of consulting with people who use the service and staff has been developed for Mencap Care Homes since the last inspection. Staff look at all areas of practice in Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: the home in relation to the people who use the service, the team and the environment, we were able to see an example of work that had been carried out by the staff team and areas identified for improvement. We were able to see the guidance and prompts for the gathering of this information. The consultation document to be completed by people who use the service is produced in a clear format with a tick box or comment section as a response to questions. Monthly checks are made on health and safety in the home. A very good innovative system of including people who use the service had been introduced whereby they assist staff in this. We were able to see a sample of the forms used to complete this check. There is a basic picture of the task to be completed on the forms. We looked at sample of health and safety records. We saw the record for weekly hot water checks, and fire extinguisher checks. A fire drill had taken place in May 2009 whereby a full evacuation had taken place. A fire risk assessment for the premises was dated 18th July 2009. The fire safety system was serviced in July 2009 and a Landlords Gas Safety Certificate was given in November 2008. Mencap has policies. procedures and guidance for staff on health and safety. Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes R 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 1 32 18 (1) (a) The Registered Provider must 01/06/2008 ensure that all staff are given the opportunity to progress their knowledge and skills to NVQ Level 2 or 3. Care Homes for Adults (18-65 years) Page 22 of 24 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 Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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