Inspection on 21/10/08 for Hartley House

This is the latest available inspection report for this service, carried out on 21st October 2008.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hartley House 25/07/06

Hartley House 17/02/06

Hartley House 05/07/05

Hartley House 07/10/04

Hartley House 06/05/04

Hartley House 07/01/04

Hartley House 12/06/03

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

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Rugby House Project

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOME ADULTS 18-65 Hartley House 31 Madeley Road Ealing London W5 2LS Lead Inspector Robert Bond Unannounced Inspection 21st October 2008 10:00 Hartley House DS0000027732.V372888.R02.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 Hartley House DS0000027732.V372888.R02.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. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartley House Address 31 Madeley Road Ealing London W5 2LS 0208 997 0022 0208 810 5384 steve.smith@turning-point.co.uk www.turning-point.co.uk Turning Point Limited 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) Stephen William Smith Care Home 12 Category(ies) of Past or present alcohol dependence (12) registration, with number of places Hartley House DS0000027732.V372888.R02.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. Past or present alcohol dependence - Code A The maximum number of service users who can be accommodated is: 12 15th January 2007 Date of last inspection Brief Description of the Service: Hartley House is a well-established service offering rehabilitation for the maximum period of six months, for people who have an alcohol dependency and wish to adopt an alcohol free lifestyle. The establishment is owned and managed by Turning Point. Turning Point is a national social care charity providing a range of community based projects for people recovering from alcohol and drug addictions, mental illness and learning disabilities. Turning Points first service was opened in 1964. Hartley House accommodates a maximum of twelve men or women. There are 10 single bedrooms and one double room. The service provides group therapy and one to one key work sessions. Emphasis is also placed on residents’ participation in the community. The home has a pet cat. The home is staffed from 9am - 5pm Monday to Friday. Residents can contact staff outside of these hours on a free phone number. The cost is £477 per week. Hartley House DS0000027732.V372888.R02.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 3 star. This means the people who use this service experience excellent quality outcomes. This was a key inspection that considered the outcomes of the key National Minimum Standards (NMS) for care homes for younger adults as published by the Department of Health. The last key inspection was undertaken on 15th January 2007 at which 3 recommendations but no requirements were made. We also undertook an Annual Service Review on 19th February 2008 for which surveys of residents were undertaken. The findings are included within this report. This inspection involved touring the premises, interviewing the Registered Manager, meeting other staff and residents and examining a range of files and records. Turning Point’s Locality Manager arrived during the inspection. We obtained on the day of the inspection a copy of the home’s Annual Quality Assurance Assessment (AQAA). Throughout the inspection, equality and diversity were considered but no adverse issues came to light. On the day of the inspection 10 residents were present and the home was fully staffed. 32 residents have lived in the home during the last 12 months. In total, we assessed the outcomes of 24 NMS, and found that 13 were fully met, and 9 were exceeded, whereas 2 were only partially met. This led to us making 3 requirements and 2 recommendations. What the service does well: What has improved since the last inspection? Turning Point has appointed an Equality and Diversity Officer and holds a London-wide Diversity Forum that includes a representative from Hartley House. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 6 The care planning system has been changed so that new residents are issued with an initial primary care plan and subsequently a more detailed main care plan is developed, sometimes by the residents themselves. Clinical risk assessment forms have been introduced. The range of optional group sessions has increased and Service User Involvement Group meetings have commenced. Some new furnishings, a large screen television, and garden furniture have been purchased. The home is now fully staffed and a former resident is used as a volunteer to help new residents settle in. All the staff are undertaking NVQ awards. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. 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. Hartley House DS0000027732.V372888.R02.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 Hartley House DS0000027732.V372888.R02.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): 1, 2 and 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The information provided by the home to prospective residents and their representatives is very good, and the contracts in place are excellent. Thorough assessments of need are undertaken, including excellent clinical risk assessments. EVIDENCE: We examined a copy of the home’s Statement of Purpose and the contracts that are issued. There are Placement Agreements and each resident has a licence agreement to occupy their room. There are also ‘self-protection contracts’ that detail rights and responsibilities of residents. This is commended. We examined at random three current care files and found that each contained referral documentation from a local authority, and detailed assessments of need undertaken by staff from Hartley House. The use of detailed ‘clinical risk assessments’ is also commended. Hartley House DS0000027732.V372888.R02.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 excellent. This judgement has been made using available evidence including a visit to this service. Individualised care plans that are available from day one of the admission are excellent. The content of risk assessments, and the review system are excellent. The extent of the involvement of the residents in operating the care home, and the promotion of supported independence, are also excellent. EVIDENCE: We examined at random three care files of current residents. Each contained a primary care plan of general aims and objectives, created on the date of admission, and a main care plan written after approximately three weeks. This system is commended. Typical headings in the main care plan are personal/emotional needs, relationships, social needs, medical/health needs, and cultural needs. Residents often draft their own care plan, which is commended. Care plans are reviewed on a two monthly basis. The extent of resident involvement in care plan construction, risk assessment processes, and the operation of the home is also commended. Residents shop, cook and clean the home. Daily lunch-time group meetings are held to discuss routine matters, and a weekly group meeting considers policy matters. There is also now a 6 weekly Service User Involvement Group meeting. The home has a volunteer who is a former resident who befriends and advises new Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 10 residents. There is however no independent advocacy scheme in operation. Residents look after their own finances and own medication. The emphasis of the home is very much on responsible risk taking, responsibility and the promotion of independence. Clinical risk assessments are undertaken that include aspects such as self-harm, and alcohol relapse. These risk assessments are reviewed at frequent intervals. The premises are risk assessed, as are the various activities undertaken by residents. The risk management strategy of the home is commended. Hartley House DS0000027732.V372888.R02.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 good. This judgement has been made using available evidence including a visit to this service. The range of educational and leisure activities available to residents is very good, as is the food served within the home. EVIDENCE: The Registered Manager explained that Hartley House is a ‘second stage’ home where residents may stay for up to six months having completed elsewhere a programme of detoxification from alcohol addiction. The home offers a programme of therapeutic activities such as group therapy sessions and art therapy. Residents are encouraged to go out and lead a normal life without alcohol. Hence college attendance is encouraged, as is going to the gym or swimming. At present one resident is learning sign language. Hartley House will pay for residents to undertake such activities and ‘travel cards’ are supplied. There are particular links with Thames Valley University for IT training and the home now has a computer for residents’ use. Links with family and friends are encouraged provided these are not contra-indicated as likely to encourage the drinking of alcohol. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 12 For the first two weeks of their stay, residents may not leave the premises without another resident or the new volunteer to escort them. Visiting times are restricted so that group therapy times are not disrupted. Residents are issued with a bedroom key and a lockable cabinet. Bedroom searches are not conducted but staff may enter a bedroom for a health and safety check. Random breath and urine tests are undertaken to ascertain whether a resident has started drinking alcohol again. We observed a meal being prepared by a resident, and subsequently being enjoyed by residents eating in a communal setting. Records are kept of food consumed on an individual basis. As staff are not normally present at weekends, residents are given money to buy communal food for these times. The receipts are subsequently checked to ensure that the food bought is of a sufficiently nutritious standard. Fresh fruit was freely available, which is commended. Hartley House DS0000027732.V372888.R02.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 using available evidence including a visit to this service. Residents are well supported and facilitated to look after their own personal care, health care and medication needs. EVIDENCE: Personal or intimate care is not a service that Hartley House offer assistance with, however the AQAA completed by the service says that individual needs are taken into account when allocating a key worker. All residents are able to self-medicate and are supported to manage their own medical conditions. The volunteer will accompany residents to hospital appointments where necessary. Residents can retain the services of their own GP, or use those of the GP who has agreed to take on Hartley House residents. A similar arrangement exists regarding a dentist. Each resident is provided with a lockable cabinet where their medication can be stored. No controlled medication is used. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents can be assured that any complaint they make will be fully investigated, and that excellent procedures are in place to protect them from abuse, neglect or self-harm. EVIDENCE: We examined the home’s complaints procedure that is made available to residents as part of the Service Users’ Guide (Residents’ Handbook). The procedure mentions that complaints can be made via the CSCI. The home’s complaints’ record showed that one complaint had been received during the last 12 months. The complaint had been sent to the London Office of Turning Point, and had been addressed by them. The home has a ‘suggestions box’. We noted that the home has a copy of the London Borough of Ealing’s Safeguarding Adults procedure, which is referred to within the home’s own procedure. We saw records that demonstrated that staff members had been trained in POVA. No Safeguarding Adults referrals had been made during the last year. A clinical risk assessment is undertaken on each resident that considers matters such as self-harm. Residents also sign a self-protection contract that includes an agreement to report the actions of others who may be a danger to themselves. This is commended. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 15 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. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment that is clean and hygienic. EVIDENCE: We toured the premises, including three residents’ rooms, with their permission. We noted new communal easy chairs, chair covers, widescreen television in the non-smokers’ lounge, and new garden furniture. One bedroom is a double room, with a screen between the beds, but this room was not currently occupied. It does however need to be redecorated. Elsewhere a bathroom was noted where an electrical point had been removed but not yet ‘made good’. No smells or dirt were noted anywhere. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 16 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 using available evidence including a visit to this service. Residents are well supported by sufficient staff, who have been interviewed and are undergoing thorough training. EVIDENCE: The home is fully staffed with a Manager, Administrator and 3 Project Workers. All were present on the day of inspection. Staff work weekdays only but there is an on-call system for nights and weekend days. Two Project Workers are undertaking NVQ’s and the third worker will commence an NVQ after her probation period is completed. We saw induction and other training records, and plans for future training and development of staff based on a thorough supervision and appraisal system. We examined a recruitment file and found that the applicant had been interviewed but that the full Turning Point process for recording the outcome of the interview had not been completed. Recruitment papers are sent to Turning Point for them to send for references and CRB clearance. The recruitment file did not contain any letter or email from Head Office to confirm that satisfactory references and CRB had been obtained. CSCI ‘policy and guidance for service providers’ published October 2008 says that where CRB disclosures are stored away from the service, the registered provider must make sure that records Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 17 are kept at the service that confirm that the check was made and what it’s outcome was. Annex 4 of the CSCI document can be used for these purposes. The volunteer has been CRB cleared. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 18 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, 39 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed home where quality assurance and health and safety receive excellent attention. EVIDENCE: The Registered Manager is currently working towards his NVQ 4 in health and social care which will also form his Registered Managers’ Award. He already has the NVQ A1 Assessors Award. No requirements were made at the last inspection and only two requirements are made at this inspection which is indicative of good management. Quality Assurance is maintained by an Internal Quality and Assessment Tool, by regular Regulation 26 visits from the Locality Manager, monthly provision of data to Turning Point, and an annual service audit. This extent of quality assurance is commended. Feedback from residents is formally obtained via questionnaires, and informally on a daily basis. Typical quotes we obtained when doing our Annual Service Review were, “Staff are very helpful, kind and Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 19 easy to talk to. I have felt settled since the day I moved in. The home is always clean and tidy.” In terms of health and safety, we checked the hot water supply, the fridge and freezer temperatures, and the storage of cleaning materials. We noted examples of the monthly ‘house-keeping’ health and safety audit and the quarterly health and safety compliance check undertaken for the Turning Point Head Office. As reported elsewhere in this report, detailed risk assessments are undertaken. This level of health and safety awareness and action planning is commended. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 20 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 3 2 4 3 x 4 x 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 4 x x 4 x Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 21 no Are there any outstanding requirements from the last inspection? 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 2 3 Standard YA24 YA24 YA34 Regulation 23(2)(d) 23(2)(b) 19 Requirement The double bedroom must be redecorated. Where electrical points have been removed from bathrooms, the work must be ‘made good’. The service must keep on the premises for the purpose of inspection evidence that satisfactory recruitment references and CRB disclosures have been obtained for all employees and volunteers. Timescale for action 01/05/09 01/05/09 01/12/08 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 2 Refer to Standard YA7 YA34 Good Practice Recommendations That the management of Hartley House further consider whether an independent advocacy scheme could be made available to residents. That the Turning Point recruitment selection forms are fully completed to show the outcome of each interview. Hartley House DS0000027732.V372888.R02.S.doc Version 5.2 Page 22 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. 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