Care Home: Richford Street, 60

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What the care home does well All of the residents are up to date with their person centered planning reviews,records looked at were relevant and up to date. We looked at two residents PCP reviews that were very informative showing photographs and pictures of what support each individual required. We were told by all three residents that are happy living at Richford Street. The environment is now comfortable and homely for all of the residents, we had a full tour of the home and also spent time with two residents looking at their bedrooms. What has improved since the last inspection? We looked at the training records of all staff working at Richford Street, all staff are now up to date with training. There is a new member of staff that is currently going through the organisations induction programme. The home has had a full redecoration inside and outside the premises, we were told by all three residents and staff that they are happy with the work that has taken place. The home is now comfortable and is suitable for its stated purpose. What the care home could do better: We looked at the statement of purpose that does require up dating and requires more information about the home to be included. We discussed the safeguarding policy and procedure with the registered manager and a member of staff, the registered manager does have to attend up to date training to be more aware of his responsibility in meeting the local authority`s procedure. The registered manager must also make sure that the home has the local authority`s policy and procedure as well as Yarrows for staff to refer to if required. We looked at the training records of all staff and all staff have attended safeguarding training. We had a full tour of the home and spent time in the kitchen and dinning room. The lino floor is need of replacing in both areas as it is starting to rip and is now becoming a health and safety risk as residents and staff could trip over. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Richford Street, 60 Richford Street 60 Richford Street Hammersmith London W6 7HP     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: Jackie Derbyshire     Date: 2 7 0 3 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 29 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 29 Information about the care home Name of care home: Address: Richford Street, 60 Richford Street 60 Richford Street Hammersmith London W6 7HP 02087499295 Telephone number: Fax number: Email address: Provider web address: lawrence.dawson@yarrowhousing.org.uk Name of registered provider(s): Type of registration: Number of places registered: Yarrow Housing Limited care home 3 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: 3 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gende 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 60 Richford Street is a registered care home providing accommodation and support for two women and one male. Shepherds Bush Housing Association owns the property and the care is provided by Yarrow Housing Limited, a voluntary organisation. The home is located in a residential area, close to the shops and transport links of Shepherds Bush and Hammersmith Broadway. The accommodation is arranged over three floors, the home has a back garden that is used by the residents. The home does Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 Brief description of the care home not have a lift; access for people with a physical disability would be difficult. The weekly fee for Richford Street is 859.00 Care Homes for Adults (18-65 years) Page 5 of 29 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 2 star. This means the people who use this service experience adequate quality outcomes. Throughout this report the word we will be used as meaning the CSCI. This unannounced inspection took place on Friday 27th March 2009, we spent 4.00 hours visiting the home. We spent time talking to all three residents, the registered manager and a member of staff. We checked the care records of two residents and all medication and finance records were looked at. We had a full tour of the home and looked at two residents bedrooms. Richford Street has had full redecoration completed internally and also externally. The home was in a good state of repair and residents told us they are happy with the decor in the home. We received two residents surveys and a one staff survey, comments from the surveys will be included throughout this report. 5 requirements set in June 2008 have all been fully met, 3 new requirements Care Homes for Adults (18-65 years) Page 6 of 29 have been set from this inspection. We will make reference to the AQAA Annual Quality Assurance Assessment throughout this report. 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 29 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 29 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. The home provides a statement of purpose that is specific to the individual home and the resident group they care for. The home does need to up date the document to inform residents and stakeholders of the homes aims and objectives. Evidence: Comments from residents and staff. I really like living here The home provides all of the residents with the required support and staff do promote people being independent. We looked at the statement of purpose and service user guide, the statement of purpose requires to be up dated and include all information on the aims and objectives and philosophy of Richford Street. Two residents have lived in the home for over 20 years and one resident over a year. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: We looked at records in two residents files that show that their needs are assessed and reviewed regularly. Person centered plans were looked at with risk assessment records that worked in conjunction with the PCP records. We looked at two residents agreements, the records were up to date and are reviewed annually. Both records were signed and dated by the residents.All original contracts are kept at the Yarrow head office. Care Homes for Adults (18-65 years) Page 11 of 29 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. The service will know and record the preferred communication style of the individual, and will use proven methods that enable the person to lead a full life that promotes independence and choice. Staff understand the importance of all residents being supported to take control of their own lives. Evidence: Comments from residents and staff. I am independent. It is a well run house and support is given in every aspect to the residents when they need it. Residents are aware of their rights and choices. We looked at two residents files, both included person centered plans with lots of rev Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: wived records. The PCP plans are informative and relevant to each individuals needs. The PCP plans do reflect the aims and aspirations of the residents, one showed that the individual would like to go on holiday, which they did. Another resident had that they would like to go with staff to a local cafe as they liked the tea, this happens on a regular basis. The PCP plans do reflect the individuals health and social care needs and how the staff are meeting each persons needs.The PCP were in pictorial formats and also on DVD, showing how the individuals are involved in their person centered plans. All three residents were seen to prepare their breakfast and made themselves hot drinks, staff were seen to promote the residents independence assisting them when requested and not telling the residents what to do. We looked at the risk assessments for two residents, all of the risk areas identified in the care plan had an action plan in place to inform staff of the risk and how to eliminate or minimize the risk. the risk assessments did work in conjunction with the care plans. Care Homes for Adults (18-65 years) Page 13 of 29 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 involved in meaningful daytime activities of their own choice and according to their relevant interests, diverse needs and capabilities. Evidence: Comments from residents. I like going to work. I go out every day I am happy. We looked at the person centered plans of two residents, the records contained a lot of information about each residents likes, dislikes, hobbies and leisure interests. We also looked at the daily records for all there residents that had information about what activities they had done daily that included attending a local cafe, going to the local Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: community center called the Gate, attending sewing classes, art classes, discos, eating out, and for one resident attending work. One of the residents chooses not to do as many activities as they enjoy being with the other residents, going to a local cafe and spending time in the lounge with the house cat. We looked at the contact information for two residents, one resident contacts a friend on the telephone on a regular basis. Another resident goes to spend time every other weekend with family. In discussion with the registered manager we were told that residents are always encouraged to continue relationships with their family and friends. We were told by the registered manager that the big shopping is done weekly and staff and residents will shop more regularly for perishable items. We saw a lot of fresh food at the home. We were told by residents that they enjoy the food, residents were seen to help themselves to breakfast and hot drinks when they wanted them. One residents has a special diet and staff will liaise closely with them to make sure they are provided with variety. We saw the weekly menu that is pictorial format in the kitchen, residents choose the menus at their weekly house meeting. The AQAA form completed does go into detail about the different diverse needs of the residents and how staff do try to provide a varied menu. Care Homes for Adults (18-65 years) Page 15 of 29 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. People receive personal and health care support using person centered approach with support provided based upon the rights and dignity, equality, fairness, autonomy and respect. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each person centered plan. Evidence: Comments from residents and staff. I have my own doctor. I am happy taking my own tablets, staff always remind me. We looked at two residents files, both included information on what level of support they require. On the day of this site visit staff were seen to be encouraging the residents, personal and health care support is provided in a person centered way. All three residents are able to do their own personal care with little staff support. We saw information on how the home had liaised with other professionals including speech and language therapists, psychologists and social workers. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: All of the residents living at Richford Street are registered with a local GP. We looked at the medication records for all three residents that were well recorded. One of the residents is supported to be independent in taking their medication and it is kept in their own room, records show that staff check with the resident on a regular basis. We looked at staff training records and all staff have attended medication training. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. It is available in different formats to help anyone staying at or involved with the service to complain or make suggestions for improvement. Evidence: Comments from residents and staff. I will speak to staff if I am not happy. We take complaints seriously and all residents are aware of the homes complaint procedure. We looked at the complaints file that had a complaint logged, however the information was not in place. We were told by the registered manager that the information was at the head office as an investigation had taken place. The complaints procedure was on the residents notice board in the dining room. The complaints procedure is available in different formats including pictorial. We spent time discussing the safeguarding policy and procedure with the registered manager and a member of staff. The registered manager discussed the complaint that had linked into the safeguarding procedure, the registered manager must make sure that the organisations policy and procedure and the local authority procedure is in Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: place for staff to follow if an incident occurs. The member of staff told us that they had attended safeguarding training and they were knowledgeable about what they should do if an incident occurred at the home. We looked at the training records of all staff and all staff except the new member of staff have attended training, we were told that the new member of staff will be attending training as part of their induction. Care Homes for Adults (18-65 years) Page 19 of 29 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 standard of home is reflected in the statement of purpose, it is comfortable and homely. Residents are encouraged to personalize their own bedrooms. All of the homes fixtures and fittings meet the needs of individuals and can be changed if their needs change. The home is not accessible for people with a physical disability as there is no lift to access the lower ground or two upper floors. Evidence: Comments from residents and staff. I am happy with my bedroom. I like living here its my home. I think the home looks nice now and its more comfortable for the residents. We had a full tour of the home and all areas were seen. Richford Street had a full redecoration programme in October 2008. The interior and exterior of the home was decorated, we were told by all of the residents that they are happy with the decor. We spent time with two residents in their bedrooms that were seen to be comfortable and had a lot of personal items in place. New curtains were seen in the two residents Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: bedrooms, we were told that they had chosen them and they liked the colors. We looked at all communal areas of the home, the lounge was comfortable, the bathroom had been decorated. The kitchen was fit for purpose. The flooring in the dining room and kitchen area is starting to come up and tear, this is a health and safety issue, we were told by the registered manager that this has been reported to the organisation. The lino floor must be replaced so that residents and staff are not at risk of tripping. The home was clean, tidy warm and bright on the day of this site visit. Care Homes for Adults (18-65 years) Page 21 of 29 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. There is now enough staff available to meet the needs of all residents. Staff rotas take into account the needs and routines of the people using the service. Evidence: Comments from residents and staff. I like the staff. A very good staff team who always help each other. We looked at the staff rota for March and April 2009, there was adequate staffing on each shift to meet the needs of the three residents. We spent time discussing staffing with the registered manager and was told that there are no vacancies in Richford Street. We were told by residents that they liked all of the staff. We were told by a member of staff that the team work closely to make sure that all of the residents needs are fully met. We were sent the CRB information on all staff and bank staff currently working at Richford Street, all disclosures were up to date. We looked at the training records of all staff that show that all staff are up to date with training, there is a new member of Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: staff who is currently completing induction training. We spent time at the organisations head office in December 2008 looking at staff recruitment records, all of the relevant checks were seen to be in place. All staff recruitment records are kept by the human resources team in safe storage at the head office. The registered manager has completed an NVQ level 4, we spent time discussing the continuous training with the registered manager. Records were looked at showing that he is attending training and keeping himself up to date in the organisations training programme. There is currently two members of staff with an NVQ and two who are registered to complete the qualification. Care Homes for Adults (18-65 years) Page 23 of 29 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 a clear understanding of the key principles and focus of the service, based on the organisational values and priorities. Evidence: Comments from residents and staff. Full support is always given from the manager. I am happy living here. The registered manager has worked at Yarrow for many years and is very experienced, the registered manager has an NVQ level 4. We spent time throughout this site visit discussing all areas of running the home, the registered manager is very positive about the care provided by the staff team and discussed the person centered approach that all staff follow making sure all three residents independence is promoted. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: We spent time discussing the organisations quality assurance procedure with the registered manager. We looked at questionnaires that Had been completed by residents, advocates and other professionals that work with the residents. We saw a lot of positive comments about the staff and care provided at Richford Street. The organisation produces an annual survey of all of the homes including Richford Street. We were given in formation in AQAA returned that shows that all health and safety checks are completed on a regular basis. We looked at records for checks for the fire alarm system,tests and evacuation records, safe food storage, water temperatures and gas and electric maintenance, all were seen to be well recorded and up to date.All staff training records were looked at and all staff except a new member of staff have completed first aid training. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 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 1 1 6 The homes statement of 27/06/2009 purpose must include all relevant up to date information about the home. To inform prospective people and residents of the homes aims, objectives and philosophy. 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 23 13 The registered manager must make sure that the organisations policy and procedure and the local authoritys procedure is in the home. For all staff to refer to and follow the correct procedure if a safeguarding incident occurs 01/05/2009 2 24 22 The organisation to replace the lino flooring in the dinning room and kitchen. To make it safe for residents and staff to walk on. 27/05/2009 Care Homes for Adults (18-65 years) Page 27 of 29 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 28 of 29 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 © (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. 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