Random inspection report
Care homes for adults (18-65 years)
Name: Address: 6 Honister Gardens 6 Honister Gardens Stanmore Middlesex HA7 2EH two star good service 14/10/2008 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Robert Bond Date: 0 4 1 1 2 0 0 9 Information about the care home
Name of care home: Address: 6 Honister Gardens 6 Honister Gardens Stanmore Middlesex HA7 2EH 02089070709 02089070709 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Striving For Independence Group Homes care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 5 The maximum number of service users who can be accommodated is: 5 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: Learning disability - Code LD Date of last inspection Brief description of the care home 6 Honister Gardens is a care home providing personal care and accommodation for up to five people who have a learning disability. The home is owned and run by the Striving For Independence organisation, a local private and independent care service provider. The home has 24-hour staffing. 1 4 1 0 2 0 0 8 Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home The home is located within a residential area on the edge of both Stanmore and Belmont, in the borough of Harrow. It is a few minutes from bus links, and around ten minutes walk from local shops. Parking restrictions do not apply on the road outside the home. The drive has space for two cars. The premises are a two-storey building in keeping with other homes in the street. All bedrooms are single rooms, fully furnished, and with built-in wash-basins, both upstairs and downstairs. One bedroom has an en-suite toilet. The home has one bathroom with adapted shower facility upstairs, and a shower room downstairs. The home has a kitchen, a lounge leading into a dining area, a spacious activities room upstairs, and a garden. There is also a passenger lift. Management stated that information about the fees, and a copy of the service user guide, are available in the home on request. Care Homes for Adults (18-65 years) Page 3 of 11 What we found:
This random inspection was undertaken in order to inform an Annual Service Review of the service. The inspection was done on an announced basis so that we could be sure that the Registered Manager would be present. As this was not a key inspection, there was no intention of us inspecting all of the National Minimum Standards, or even all of the key standards. The inspection lasted approximately three hours. During this time we talked at length with the Registered Manager, talked with the one resident present that afternoon, met the Proprietor and one member of staff, toured the premises other than the occupied bedrooms, and examined a number of documents. The one resident, who was an older man, was asleep in his room for most of our afternoon visit. He then got up and watched childrens television in the lounge. The home had two resident vacancies on the day of our inspection. According to the Annual Quality Assurance Assessment we had received from the home in advance, one resident is aged 26 and two residents are aged 68 years. We had received a recent notification of assault by the young resident on one of the older residents that had led to a Safeguarding Adults strategy meeting. As a result we examined risk assessments that had been undertaken by the home on the two residents concerned, checked staff rotas, and looked at the homes Safeguarding Adults policy and procedures and training records for the Protection of Vulnerable Adults. We also ascertained whether the requirements we had made at the last key inspection had been fully complied with, which they had. We asked the Manager to provide us with the contact details of the next of kin of the three residents so that we could send surveys to them. One of the addresses we were supplied with had the incorrect postcode, but we were able to correct that. We were told that one resident had no next of kin but we were given the mobile phone number and first name (only) of an advocate who knew him. We subsequently spoke by telephone to the advocate who said she had been invited to attend a care review of the resident at only one hours notice, and hence had been unable to attend. It became clear however, without confidences being breached, that she had not been made aware of this residents assault within the home, nor his trip to hospital, nor the Safeguarding Strategy meeting that had discussed his case. Hence a recommendation is made that, together with his placing authority, the role of the advocate in this case should be reviewed and possibly formalised. What the care home does well:
The Registered Manager has been proactive in complying with the four requirements that we made at the last key inspection that had been undertaken on 14th October 2008. The Registered Manager has also been quick to improve the homes Statement of Purpose and the homes Service Users Guide following the omissions we pointed out during the inspection. She has also taken steps to obtain The London Borough of Harrows latest
Care Homes for Adults (18-65 years) Page 4 of 11 Safeguarding Adults policy and procedure. The home is currently making more of its written documents accessible in picture format to the residents. The risk assessment documentation is also being updated. What they could do better:
We found that the Statement of Purpose as shown to us on the day of the inspection was out of date in that it said 4 out of 6 bedrooms were available for residents. The figure is currently 5. We therefore agreed that a revised Statement of Purpose could be emailed to us the following day. This revised version however fails to meet the National Minimum Standard in two ways. Although it names the home as Honister Garden Home, it fails to give the address. Paragraph 1 of Schedule 1 of the Care Home Regulations asks for the name and address of the Registered Manager, and the address of the care home is usually quoted here at least. Secondly the Statement of Purpose says that the home provides care and accommodation for people aged 18-65 with learning disabilities. Thus with two residents aged 68, one of them newly admitted from another home operated by the same provider, the home is operating outside of its own documented parameters. We were shown a picture assisted version of the Service Users Guide. The section on how to make a complaint said if you are not happy, speak to Deborah (the Manager). There was no indication what the resident should do if they were not satisfied with the Managers response, and no mention of how the Care Quality Commission could be contacted, as required in the Standards and in the Regulations. As indicated above, the older resident we met slept for most of the afternoon, and when he was awake, the member of staff present turned on the television for him but that was all in terms of stimulation or conversation. The relative of one resident subsequently completed a questionnaire for us and said she was concerned that he also spends too much time with staff and in his room. She also wrote that he may have been too long in the same place and needs more young people around him Therefore, given both of our concerns about a possible lack of stimulation and about the age mix in the home where two of the residents are older enough to be the grandfathers of the young resident, we are requiring that we be sent evidence of recent reassessments and care reviews that have involved care managers and relatives and that have considered social care needs, activity and stimulation provision. If such reviews have not taken place within the last six months, they will need to be arranged. This request is in line with the email dated 4th October 2007 sent to you by Clive Heidrich that said; As long as people are admitted into the care home with primary care needs of learning disability, and as long as you can continue to meet these peoples needs, you would not be in breach of registration for accommodating ...(people over 65 years of age). We asked to see the homes Safeguarding Adults policy and procedure for the London Borough of Harrow as the home is in that Borough. We were shown a version marked Working Draft and dated 9th August 2001. As changes to this document may have been made since, a requirement has been made that the latest version must be obtained. Care Homes for Adults (18-65 years) Page 5 of 11 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 2. Care Homes for Adults (18-65 years) Page 6 of 11 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 11 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 1 4 The homes Statement of 01/01/2010 Purpose must provide up to date and accurate information and contain the information required by Schedule 1 of the Care Home Regulations. This is because the CQC inspects services against what appears in the Statement of Purpose, and because commissioners of services judge the service partly on what appears in the Statement of Purpose. 2 1 5 The picture version of the Service Users Guide must describe the stages of the homes complaints procedure, including providing the contact details of the Care Quality Commission. Otherwise service users and their relatives may not know where to take their complaint. 01/01/2010 Care Homes for Adults (18-65 years) Page 8 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 3 6 15 The home must provide 01/02/2010 evidence to the CQC that formal reassessments and reviews have been undertaken by or together with the commissioners of the service for each of the current residents within the last six months, that consider in particular how the home is able to meet the residents needs for social activities and friendships with people of similar ages. The age discrepancy between existing residents is such that special measures may be necessary to ensure that all residents are sufficiently stimulated. 4 23 13 The Registered Manager must obtain the latest version of The London Borough of Harrows Safeguarding Adults policy and procedure. Otherwise correct and timely procedures may not be followed. 01/12/2009 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 1 6 That the management of the home reviews, together with the relevant placing authority, the role of the advocate who supports the resident without any close realtives, and
Page 9 of 11 Care Homes for Adults (18-65 years) 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 possibly formalises this role, so that the residents interests are consistently represented on all appropriate occasions. Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 11 of 11 - 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!
