Inspection on 06/09/05 for 23 Hathaway Road

This inspection was carried out on 6th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

23 Hathaway Road 31/07/07

23 Hathaway Road 03/08/06

23 Hathaway Road 23/03/06

23 Hathaway Road 15/03/05

23 Hathaway Road 14/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Hathaway Road (23) 23 Hathaway Road Grays Essex RM17 5LB Lead Inspector Pat Stanton Unannounced 6 September 2005 th 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 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 Stationary 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. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hathaway Road (23) Address 23 Hathaway Road Grays Essex RM17 5LB 01375 383556 01375 373242 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Thurrock Council Joyce Kathleen Tree CRH Care Home 4 Category(ies) of LD Learning Disablilties (4) registration, with number of places Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Personal care to be provided to up to 4 service users with learning disabilities who require a short break service only. 2. Personal care to be provided to up to 4 service users with learning disabilities under the age of 65 years. 3. Number of service users whom personal care is to be provided shall not exceed 4. Date of last inspection 15th March 2005 Brief Description of the Service: 23-25 Hathaway Road provides a short break service for Younger Adults with a learning disability. The Home is situated in the centre of Grays and is a short walk to the High Street, bus and train stations. The premises have been extended and are made up of two properties which have been amalgamated into one building. Care has been taken to ensure the premises remain in keeping with those in the locality. The home is maintained, decorated and furnished to a good standard. The Home provides four single bedrooms and is in keeping with a traditional family style home. There is no off-street parking and parking outside the home is by permit only. The Home has a ramp leading to the side door and two reasonably sized rear gardens Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The routine unannounced inspection took place on the 6/9/2005. At inspection two residents, one staff member and the registered manager were spoken to. One staff member gave the inspector a tour of the premises and records and documents were looked at. Time was spent in the lounge chatting and taking note of the two residents in the home. The residents, staff and the manager on duty were most helpful, and this was greatly appreciated. The inspector would like to take this opportunity to thank the residents’, staff and registered manager for their hospitality and cooperation during the home’s inspection. What the service does well: What has improved since the last inspection? The home has improved the service users guide and statement of purpose to suit residents and provides a more comprehensive pre assessment tool, to ensure all relevant information is gathered prior to making a decision about admissions. Medication sheets have been updated to include some of the relevant information as required by this standard. The homes front garden has been improved. Some of the homes policies have been updated to assist staff improve care. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 6 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. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,4. Prospective service users have the information they need to make an informed choices prior to moving into the home and know their individual aspirations and needs will be met. New residents have the opportunity to visit and testdrive the home prior to admission. EVIDENCE: The home had improved the service users guide, which is produced in a suitable format for residents to include pictures and clear statements. The guide included details for residents regarding money, how to make a complaint, residents’ rights, staffing, activities in the home with health and safety procedures. The statement of purpose is comprehensive and clear, giving all relevant information. The registered manager stated residents have the opportunity to visit the home to meet other residents and staff and may stay overnight if required before making a decision regarding admission. Resident’s relatives are involved in the process of pre assessment when applicable and the home employs a link social worker who assesses all referrals prior to the homes, more comprehensive pre assessment. Files examined contained all possible information regarding the resident and gave every detail of the residents likes dislikes and abilities. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10. Care plans do not reflect changing needs and personal goals of residents but residents do make decisions about their lives with the assistance of staff. Residents are consulted on most aspects of life in the home and supported to take some risks as part of their independent lifestyles. Information about residents is handled in confidence. EVIDENCE: Care plans from the placing authority give clear instructions of the changing needs of residents with instruction on how to meet these goals, but the homes internal plan did not reflect the needs. In one case, the local authority’s plan stated the resident would benefit from using a computer, cooking with a microwave and training in independent living skills. The staff’s daily notes did not evidence the resident had carried out any cooking, use of a computer or capabilities with regard to daily living skills whilst staying in the home. The residents sometimes treat their stay at Hathaway Road as a holiday and do not wish to participate in daily living skills training. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 10 Staff informed the inspector the home will soon make provision for an activity room in the home with a computer for residents’ use in the near future. The registered manager stated as the home only provides short stay, house meetings for residents are not arranged. However staff do speak to residents daily, on individual basis to seek their views and opinions and at inspection residents were seen to choose activities and participate in activities of their own individual choice. Staff encourage residents to engage in a variety of activities to promote independence but one resident did not want to go out, but stay home to watch television and staff respected his wishes. Another resident went out to choose a video and was able to watch this in one of the homes two lounges both with television, video and DVD. Residents can watch alternative programmes in the home communal areas. The registered manager requests feedback from residents following discharge regarding their stay. Records confirmed residents were happy whilst staying at Hathaway House. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16,17. Residents take part in age, peer and culturally appropriate activities including the local community. Residents have appropriate personal, family and sexual relationships and their rights duly respected. Residents receive a healthy diet and enjoy mealtimes in the home. EVIDENCE: Residents spoken to had limited communication skills but were able to express their satisfaction at the level of activities and facilities in the home. One resident enjoyed his job club and his file contained a weekly activity plan whilst living in the home. The home encourages residents to be part of the community and feedback from residents following discharge confirmed they had enjoyed car rides, walking at the sea front, visitors from the cheese and wine party, pub lunches, visits to the shops and local farm. One resident’s favourite community activity was going to the pub for a whisky and coke. The same resident spoken to at inspection confirmed he was never bored and enjoyed living in the home. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 12 The home had an excellent policy and procedure for sexual health for residents with learning disability, to help staff assist residents to exercise their right to participate in personal relationships. The registered manager confirmed one resident had a girlfriend who visited and other residents invite friends and family to visit the home. One staff member stated she had training in sexual health whilst working in the home, which she found very informative. The registered manager encourages relatives to participate in residents lives and files confirmed visitors are welcome and do take residents out, although family visits are limited as they may be away. Menus and stored food examined at inspection were fresh and of good quality. Fresh food and vegetables were seen in the home and residents stated how much they enjoyed the food. Menus confirmed residents have a choice and an option of cooked breakfast every day with snacks at lunchtime and a cooked evening meal daily. Residents sometimes go out for meals with staff or have a take away. All residents diet in-take is recorded on files and residents were seen to enjoy their lunch together, in the dining room. Fresh opened food stored in the fridge at inspection was covered but not dated. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20. Residents receive personal support as they prefer and require, with physical and emotional needs assessed by the homes staff. The home does not have consent to administer first aid or homely remedies but seeks professional medical advice for all residents when required. EVIDENCE: The home provides personal care to residents in a respectful way and provides health services for residents when required. The home arranges visits to the resident’s own general practitioner or local doctor, who will attend the home if necessary. Emotional support is provided if required by staff, for the residents who are supported to continue treatment or alternative therapy. Residents usually bring in their own medication but it was noted the home does not have a record for disposal of medicines. The registered manager was advised to formulate a record for future reference and care plans did not contain consent for permission for staff to administer homely remedies or first aid. The registered manager stated when residents are unwell the doctor is always consulted. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23. Residents feel their views are listened to and acted on and are protected from abuse by the homes policies and procedures. EVIDENCE: Residents are consulted about daily decisions made in the home and included in regular care planning reviews. Residents do not however contribute to longterm decisions due to their short length of their stay in the home. Files did not contain residents’ signatures to confirm their inclusion in care planning and reviews. However the registered manager and her staff appeared to be approachable and residents were observed to voice their opinions at inspection with confidence. Staff spoken to at inspection had training in protection of vulnerable adults and were conversant with the signs and symptoms of abuse and the procedures for reporting abuse. Files confirmed no serious incidents have been reported in the home. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30. The home is homely clean, hygienic, comfortable and safe with bedrooms to suit residents individual needs and lifestyles. The home has suitable toilets and bathrooms to meet residents’ needs and shared space in the home is sufficient to suit individuals’ requirements. The home has adaptations for less able residents. EVIDENCE: The home at inspection was clean, bright, cheerful and homely decorated to a good standard. Fire extinguishers were in date and appliances checked as required. The home provides hoists, walk in shower, handrails and ramps for less able residents with sufficient well-designed bathrooms to meet individuals needs. The home does not have a lift and only one ground floor bedroom and walk in shower suite. Hence the home may accommodate only one disabled resident at a time. The entrance and garden both have wheelchair ramps. At the time of inspection the home has two good size rear gardens for residents to use with sufficient seating. The garden could be further developed to encourage older Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 16 and younger residents to use the garden more i.e. extra flowerbeds, a large inflatable pool and softball facilities. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36. The residents benefit from an established core staff who have appropriate qualifications. Staff are responsible and competent and work well as a team. Staff are supported and supervised regularly by the homes management and work effectively. EVIDENCE: The staff appeared to be experienced and competent at inspection. One carer who was working in the home on secondment from another home had received some training in learning disabilities and had brought some innovative ideas to the home which had been implemented with regard to care planning. Staff files were not examined at inspection as the keys were not on the premises but the registered manager assured all checks had been completed for staff and offered to collect the key to the files. The inspector advised the manager this would not be necessary but files would be examined at the next inspection later in the year. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 18 The home employs sufficient staff to meet the needs of residents accommodated and five of these staff members had worked in the home since it first opened. Staff on duty at inspection appeared committed to provide a high standard of care to residents. A key working system is not used because of the limited time residents are accommodated. The atmosphere was inclusive and positive at inspection and communication between residents and staff was mutually caring and respectful. One resident displayed signs of affection to staff, which was reciprocated. One staff member stated she had undertaken training since the last inspection in medication, sexual awareness, legalisation, and rectal diazepam but not conditions in epilepsy or learning disabilities. The same staff member confirmed she had received monthly supervision and stated, “The atmosphere is lovely, the care staff are caring and no one skirts work. It is a real home.” Minutes from monthly staff meetings confirmed staff were able to view their opinions and comments included details of new care plans to be introduced by the home and CSCI requirements. Both residents spoken at inspection stated how staff were nice. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42,43. The home is well run and residents benefit from a good ethos, leadership and the management approach. The registered manager has appropriate qualifications. Some of the homes policies and procedures need updating and personalising. The registered manager maintains the premises to ensure residents safety. EVIDENCE: The registered manager has qualification in advanced Care management and experience in working with people with learning disabilities. The registered manager has developed a self monitoring system for the home which could be developed further to include the views of residents’ placing social workers and relatives. Some of the homes policies examined had been updated and personalised to the home but other policies were in need of updating. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 20 Records of fire and electrical safety were examined and found to be in date and the home displays a current appropriate registration certificate. The home monitors all visitors to the home and the registered manager stated no person is allowed into the home to work unsupervised. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hathaway Road (23) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 2 3 3 I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 22 yes 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. Standard YA6 Regulation 15 Requirement The home must develop a service users care plan with consultation with the resident and their representative as to how the home will meet the needs and welfare of the resident. This plan must be kept under review. The home must maintain a system for monitoring the home and improving quality of care. Timescale for action Previous timescale not met. 1/11/05 2. YA39 24 3. YA9 4. YA41 13 (4) (c ) Risk assessments should be completed for residents daily living skills, towards independent living. 12 Policies and procedures must be 1/11/05 updated and personalised to the home. Previous timescale not met. 1/11/05 1/11/05 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 YA6 Good Practice Recommendations Residents and their significant others should sign their care plans and reviews to evidence inclusion. I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 23 Hathaway Road (23) 2. 3. 4. 5. 6. 7. YA9 YA17 YA29 YA32 YA39 YA41 The home should evidence competency of daily living skills undertaken by residents. Fresh food stored should be labelled and dated. The homes garden could be developed for residents recreational use. Staff should receive training in epilepsy and learning disabilities as the home accomodates residents with these conditions. The quality assurance system should be developed to include feedback from not only residents but relatives and placing social workers and visiting professionals. Daily notes should reflect the staff hard work and placing social workers care plan. Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BG National Enquiry Line: 0845 015 0120 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 Hathaway Road (23) I56 I06 S36448 Hathaway V242700 060905 Stage 4.doc Version 1.40 Page 25 - 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. 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