Care Home: The Swallows

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well "...The staff are very helpful and supportive...", was a comment received from the relative of one resident, who said that they feel the service is the right place for their relative, as they enjoy living at the home, and are able to pursue their own interests, with the support of staff if necessary. Findings from this inspection indicate that there is a committed manager at the home who works to progress the service. What has improved since the last inspection? At the previous inspection there had been six areas where the home had to improve. The home has taken action on all of these areas, which represents a positive response to the findings of the previous inspection, and good developments to the service. In particular, the home has been redecorated to a much more modern standard, which is appropriate and much more homely for the people who live there. Also, good work has been done to improve the medication records and information at the service. What the care home could do better: Areas where the home could be doing better are highlighted in the report and were discussed with the manager during the inspection. These include improvements to the external environment of the service and training of staff. CARE HOME ADULTS 18-65 The Swallows 183-189 Hanworth Road Hampton Middlesex TW12 3ED Lead Inspector Louise Phillips Unannounced Inspection 1st December 2008 10:30a The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Swallows Address 183-189 Hanworth Road Hampton Middlesex TW12 3ED 020 8783 0354 020 8783 0354 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Owl Housing Ltd Ms D Brenner Mr David Roger Junior Brum Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 13th July 2006 Date of last inspection Brief Description of the Service: The Swallows is a purpose-built single storey care home. The home is set back from the main road and has a wheelchair accessible well-maintained garden to the rear of the property. The home is registered to accommodate six residents with learning disabilities and is well-equipped for supporting individuals with physical disabilities or mobility problems. Each resident has their own bedroom that is specifically designed to cater for individual needs. The premises is owned by Thames Valley Housing and managed by Owl Housing and provides a service to residents referred by the London Borough of Richmond. Information about the service is available in the Statement of Purpose and Service User Guide. Current fees for the service are £1246 per week. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection took place over one day and included a visit to the service by a Regulation Inspector. When we visited we spoke to people who live and work at the home and the manager. We also spoke to one relative of a person who lives at the home, observed what was going on, looked at records and the environment. As well as the visit we asked the manager to complete a quality selfassessment. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Quality in this outcome area is good. The resident’s needs are constantly assessed and new plans made where appropriate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents have lived at the home for varying periods of time. Their care files contain information about the referral and assessment prior to their moving to the home, with details about their physical health, personal care needs, important relationships, etc. Information has also been obtained from all relevant health and social care professionals, detailing any particularly significant areas such as communication and social needs. The manager spoke about the process of assessment for new residents. He described this as a long process, to ensure the move is at the pace of the new resident, where they are fully involved in their assessment. He said that they are invited to spend varying lengths of time at the service, having lunch and dinner with the other residents, moving to overnight stays and weekend visits. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. Staff have a good awareness of the physical and personal care needs of each resident, and these are met through good care planning. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident receives care on an individual basis and observations during the inspection are that staff have a good relationship with the residents and a good awareness of their needs. All residents were individually dressed in smart, age-appropriate clothing, which the manager said they are able to choose to wear each day. The care files for two residents were looked at. These contain detailed information about the history, needs and interests of each resident. The manager described that the care plans for each resident are currently being updated to a more person-centred planning (PCP) format of care planning. The manager showed care files where this had already taken place The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 10 for some residents, where photographs had been taken of residents getting involved in what they like to do and plans for the future. Examples of this include photographs of individuals going out to places they enjoy, photos of their family and people that they like to spend time with. Included is also information about what they like, and don’t like to do or eat. Written information to accompany these plans include goals that the resident wishes to achieve, and who is responsible for helping they to realise these. There are individualised risk assessments for each resident, which have also been forwarded into risk management plans, or ‘guidelines’ to maximise the safety of the residents. These are well detailed and include activities both in and outside of the home, such as mobility, swimming, seizures and eating and diet. These include actions to take to minimise risks and the persons responsible for ensuring this. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. Residents are supported to pursue activities and maintain community links. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that during the past year the service has purchased a minibus which has enabled the residents to pursue more activities in the community. There is a pictorial daily shift plan that details the planned activities for each resident and includes domestic tasks that some of them enjoy getting involved in at the home, such as helping prepare meals, sweeping the patio and laying the table for breakfast. Each resident has a varied week that is individual to their needs, likes and dislikes. As well as attendance at day centres there are regular ‘community The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 12 outings’ when residents can go out locally with a member of staff to do such things as shopping, going to the pub or local event sin the community. One relative spoken to was very complimentary about the service, saying that they are able to visit anytime and are always made to feel welcome, where staff will make them a hot drink on arrival at the service. This relative was also very appreciative to the staff, who they said, picks them up and brings them to the service, to enable them to visit their relative easily. The manager said that each resident has been supported to have a holiday or short break over the past year. The manager said they were fully involved in choosing where to go, with some preferring a cottage or caravan holiday, whilst another attended a health spa. The staff spoke about the different likes, dislikes and cultural needs of each resident, and how they endeavour to support them to maintain their cultural identity. During the inspection, Bollywood music was heard being played for one resident. Residents help choose meals for the week ahead every Saturday. The menus are then written up and are made available in picture form, which is displayed in the kitchen. Records of meals are kept and these show that there is a good variety of nutritious and healthy meals provided. The fridge and freezer at the service were well stocked with fresh fruits, vegetables, meats and sauces. Gluten free food was also seen available for one resident with particular dietary needs. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made as the resident’s physical and personal care needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff said that some residents need support with their personal care and this was documented in the care plans. Good records are maintained of contact that residents have with health and social care professionals, dietician and speech and language therapy services where necessary. Some residents take medication, which is stored and managed by the staff. In the medication file there is a profile of each resident, including their photo, dosage of medication, description of medication and how these work. All medication and records relating to the administration of these were checked and no issues identified as needing to be addressed. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 14 The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. The home has appropriate procedures for addressing complaints and ensuring that the residents are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has an appropriate complaints procedure that provides timescales in which any complaint will be acknowledged and investigated. This is also available in pictorial format for the use of the residents and on display in the hallway at the service. There have been no complaints logged since the last inspection of the service. There are policies and procedures at the service regarding what to do in the event of an abuse allegation being made at the service. The staff training records indicate that most staff have received recent training in Safeguarding of Vulnerable Adults, and training is planned for those who still need to attend this. Staff spoken to demonstrated an awareness of what to do in the event of any abuse allegation being made at the home. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The environment is welcoming, homely and suits the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All areas of the home are spacious, airy, clean and tidy. There is a comfortable lounge which has recently been redecorated in neutral colours. The hallway has also been redecorated, and the carpet replaced with laminate flooring throughout. The home now presents as a much more modern and homely environment for the residents. Similarly, each resident’s bedroom is individually decorated and personalised to their likes and tastes. Bedrooms are furnished with specialist equipment where necessary and two had overhead tracking to assist their use of the bathroom. The kitchen has worktops that can move up and down to enable residents to prepare their own drinks and snacks. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 17 To the rear of the home is a large, accessible garden, though the ‘dips’ in the lawn make it inaccessible to wheelchair users. Also, the patio paving slabs were seen to be uneven in areas, and need to be addressed. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made as risks to residents are minimised through appropriate recruitment checks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff have been working at the service for varying periods of time, and staff feedback regarding their recruitment to the service was positive, with all stating that they had been interviewed and had received an induction to their role. At the time of inspection there are four staff vacancies at the service, with these currently being filled by bank and agency staff. The manager spoke about recruitment campaigns that they are in the process of undertaking to find suitable staff for the positions available. The staff recruitment files are held at the human resources department for Owl Housing. Evidence in the staff files confirms that the organisation carries out appropriate recruitment checks to minimise risks to residents. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 19 One staff member spoke about having completed their NVQ level 3 in Care, and that they are supported by the organisation to do this, with appropriate time off for study. Training records indicate that staff are up-to-date in training regarding moving and handling, first aid, safeguarding adults and food hygiene. There were no records available to indicate that staff had undertaken recent training in medication administration and health and safety, and it is required that all staff receive this. The files containing information about staff recruitment and training were quite disorganised and it was difficult to locate information, where it is recommended that this are organised more appropriately. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made as the manager is competent and understands the responsibilities of their role. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Feedback from staff is that they feel there is good management at the home and that they are able to be involved in the development and progression of the service. One staff member stating that: “…the service is well managed…”. The manager has worked at the home for a number of years and demonstrated a good understanding of areas that need improving and the development of the service. Records demonstrate that he attends relevant training and has completed the NVQ level 4 in Management. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 21 Quality assurance at the service is carried out via service reviews carried out by the area manager and meetings between staff and residents. Regular staff meetings are held at the service and the minutes of these demonstrate that they are used to discuss relevant issues such as those regarding residents, and ideas exchanged for managing specific issues, such as safety. Residents are able to air their views at three-monthly residents meetings. Notes from these meetings demonstrate that topics such as menu ideas, upand coming events/ celebrations and house issues are discussed. The manager said that the area manager also conducts a monthly visit in accordance with Regulation 26 of the Care Homes Regulations 2001, however the last record for this available was dated August 2008. The manager said that the previous year they sent a questionnaire to residents relatives, but that the response to this was not good, and that they are looking at other ways to get a more rounded overview of the service provided at The Swallows. Appropriate health and safety checks are carried out around the home, with records to demonstrate that up-to-date checks had been done on the electrical installation, gas safety, portable appliances and water temperatures. The service needs also keeps relevant records to demonstrate that fire systems and fire safety equipment are checked and maintained regularly. The COSHH (Control Of Substance Hazardous to Health) assessments held in the kitchen were seen to be dated September 2005, and it is recommended that more up-to-date assessments are obtained for all products used at the service. It was also observed in the kitchen cupboards and fridge, that where food jars and packets had been opened, no date had been put on these as to when this had happened, and it is required that this is carried out. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X X 2 X The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2)(o) Requirement Timescale for action 30/06/09 2. YA35 18(c) 3. YA39 26 4. YA42 16(2)(i) The Registered Persons must ensure that all areas of the home for use by residents are accessible to them, and kept in a good state of repair. The Registered Persons must 28/02/09 ensure that all staff receive training in medication administration and health and safety, and that certificated evidence of this is available. The Registered Persons must 31/01/09 ensure that visits in accordance with this regulation are carried out, and documentary evidence held at the service to demonstrate this. The Registered Persons must 31/01/09 ensure that opened jars of food are labelled with the date opened. Any ‘out of date’ food must be disposed of immediately. This is to ensure that people using the service are provided with suitable and nutritious food. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA42 Good Practice Recommendations Up-to-date COSHH (Control Of Substance Hazardous to Health) assessments should be obtained for all cleaning products used at the service. The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Swallows DS0000017369.V373312.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!