Inspection on 13/12/05 for Athelstan House

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Athelstan House 18/06/09

Athelstan House 17/07/08

Athelstan House 11/09/07

Athelstan House 22/11/06

Athelstan House 27/04/06

Athelstan House 21/02/05

Athelstan House 13/08/04

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)

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

CARE HOME ADULTS 18-65 Athelstan House Athelstan House 42 Hanworth Road Feltham Middlesex TW13 5AY Lead Inspector Paula Eaton Unannounced Inspection 13th December 2005 09:30 Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 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 Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 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. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Athelstan House Address Athelstan House 42 Hanworth Road Feltham Middlesex TW13 5AY 020 8890 3957 020 8844 0457 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) Mr Paul Martin Harrington Mrs Rosemary Wairimu Harrington Mr Brian Robert Bailey Care Home 5 Category(ies) of Learning disability (5), Physical disability (2) registration, with number of places Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2005 Brief Description of the Service: Athelstan House is a registered care home for five younger adults with learning disabilities. It is situated on a residential street and is within short walking distance to local amenities, buses and trains. There are five bedrooms in the home all fitted with en suite facilities. Two of the bedrooms are on the ground floor and three are on the first floor of the house. There are also separate bathroom facilities on each floor. There is one separate lounge and a lounge/dining area for service users. All areas were appropriately furnished. There is a large well maintained garden at the rear of the home. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two and a half hours as part of the annual inspection process. The Registered Provider’s are currently working at the home full time and only one service user was living in the home at the time of the inspection. The Registered Providers were spoken to and records, policies and procedures were examined. The service user was observed interacting with the Providers but was not able to give his views of the home as his communication skills were limited. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 6 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 Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 7 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 the following standard(s): Service users are assessed prior to admission to ensure the home is able to meet their needs. EVIDENCE: There was only one service user living at the home at the time of the inspection. This service user had been admitted to the home as an emergency placement in September 2005. A comprehensive Occupational Therapy report regarding the service user and some other basic information had been faxed to the home by the service users Social Worker two days before the service user was admitted to the home. The home had then carried out their own assessment of the service users needs when he moved into the home. The assessment documentation viewed was comprehensive and covered all areas of need. Appropriate risk assessments had also been completed. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 6, 7 and 9 Service users needs are reflected in their individual plan. Service users are encouraged to make decisions about day to day living and to take controlled risks within a safe environment enabling them to maintain as much independence as possible. EVIDENCE: The care plan for the service user living at the home was viewed. It was evident that the care plan had been developed from the assessment of the service users needs. The care plan covered all areas of need including, healthcare needs, medication and family and social contacts. The information in the care plan provided clear guidelines for anyone working with the service user. The service user had only been at the home for just over three months at the time of the inspection. Daily records were being maintained for the service user. There was no key worker system in place at the time of the inspection as the Registered Provider’s are the only staff working at the home and there was only one service user at the home. The home does not have any information available regarding any local advocacy services. The Registered Provider said that he had been considering looking for an advocate for the service user currently resident at the home as Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 9 he has very few social contacts. The Registered Provider said that the service user is able to make some choices about day to day living through using nonverbal communication although this is limited. For example, the service user can point to items and will sometimes express preferences through facial expressions. A referral had been made to a speech and language therapist to ascertain if the service user could be helped to increase his communication skills. The Registered Provider said that the service user was unable to manage his own finances and that the London Borough of Hounslow was responsible for managing his financial affairs and providing personal money for the service user at the home. Appropriate individual risk assessments for the service user had been completed and were viewed. Risk assessments were in place for falls, aggressive behaviour, and bathing. The risk assessments included the identified risk, the consequences and staff action to be taken to reduce the risk. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12, 13, 14, 15 and 17 Service users are encouraged to use appropriate amenities in the local community and to participate in appropriate leisure activities. However, this could be improved. Service users are encouraged and supported to maintain family and personal relationships. The meal provision in the home is satisfactory. EVIDENCE: The service user at the home did not attend a day centre at the time of the inspection. The Registered Provider said that the home had spoken to a local Mencap day centre and had taken the service user there a couple of times but that the service user had not wanted to get out of the car to go in. The Registered Provider said that they would explore this further. The Registered Provider said that the service user likes to go out in the car and that trips to Windsor and other local places of interest had taken place. Some in house games were also provided for the service user. However, more thought and consideration needs to be given to providing a variety of social and leisure activities to ensure the home is meeting the social and leisure needs of the service user. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 11 The service user living at the home at the time of the inspection did not have any friends or relatives that visited. The Registered Provider said that visitors would be welcomed in the home. The Registered Provider said that meal times were very relaxed and that decisions about what was to be prepared were made on a daily basis. There was no record being maintained of what the service user was having to eat. There was adequate food supplies in the home and fresh fruit available for the service user to eat. The Registered Provider explained that the service user needed some minimal assistance at mealtimes. Snacks and drinks were available for the service user between meals. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 18, 19 and 20 Personal support is provided as needed and the health needs of the service user were being met. The systems for the administration of medication were satisfactory. EVIDENCE: The Registered Provider said that service users are able to get up and go to bed when they want to and that at present there are no set routines regarding meals times, as there is only one service user in the home. The Registered Provider said that the service user needs some assistance with personal care but that he is encouraged to be as independent as possible. The service users health needs were generally being met. The Registered Provider had made contacts with healthcare professionals in the local community and made appointments for the service user. The Registered Provider said that they had had some difficulty in finding a GP in the local area for the service user but that this had now been resolved. The service user has had two hospital admissions since being at the home and is prone to falls due to epilepsy. The home has been appropriately monitoring the service users health and contacting relevant healthcare professionals as necessary. The home still had to arrange for the service user to see a chiropodist and optician. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 13 The medication in the home is currently stored in a drawer of a locked filing cabinet. This will need to be reviewed as more service users move into the home. It was noted that the medication administration records sheets were marked with an ‘x’ rather than being signed by the member of staff administering the medication, this is not acceptable. Appropriate systems had been developed for recording the receipt and disposal of medication. However, the records viewed were not accurate during the time when the service user was in and out of hospital. There were no controlled drugs in the home at the time of the inspection. The Registered Provider said that the home had not yet got the GP to sign an agreed list of homely remedies for the home. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 Service users views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. EVIDENCE: The home has an appropriate complaints procedure in place that contains clear information on how to make a complaint. There had not been any complaints received about the home. The home has appropriate policies and procedures in place for the protection of vulnerable adults. There had not been any incidents or allegations made since the last inspection. Appropriate policies and procedures were in place for dealing with service users finances. The records and monies seen were all in order. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 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 the following standard(s): 24, 25, 26, 27, 28, 29 and 30 The home provides a safe and comfortable environment for service users that suits their needs and lifestyles. There is adequate communal living space in the home. The home needs to be assessed to ensure appropriate aids and equipment are in place to meet the needs of service users. EVIDENCE: The home is comfortably furnished and safe for service users. It is very close to local amenities and transport links. The Registered Provider said that at present he deals with any maintenance issues in the home. The bedrooms in the home are satisfactory and all contain en suite facilities of a toilet and wash hand basin. The service user had brought some of his possessions from his previous home but the Registered Provider said that the home had not forwarded all of the service users possessions. There was a lockable cabinet in the room and the bedroom doors all have locks so that service users can lock their rooms if they wish to. There are adequate numbers of bathroom facilities in the home. There is a shower room, bathroom and two toilets on the ground floor and toilet and bathroom on the first floor. Both bathrooms also contain shower facilities. These facilities were maintained to a satisfactory standard. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 16 The home has a lounge/dining area to the rear of the house and a separate lounge. Both of these areas were comfortably furnished. The home has a no smoking policy so there is no need for a separate area for non-smokers. The home has a good sized kitchen and a separate laundry area in a separate building at the side of the house. The service user currently at the home has some mobility problems. There are very limited aids in the home to assist with bathing and generally moving around the home. The home needs to be assessed by an Occupational Therapist to ensure the home has appropriate aids and equipment in place to maximise the independence of the service user. The home was generally clean and tidy on the day of the inspection and there were no offensive odours. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Recruitment procedures are not always followed therefore the home is not ensuring the protection of service users. Staff in the home are not always appropriately trained to meet the needs of service users. EVIDENCE: At the time of the inspection only the Registered Providers were working at the home with one ‘back up’ member of staff available to cover when required as there was only one service user living at the home. One of the Registered Provider’s had had some training in care issues but very minimal. The member of staff recruited for covering at the home had not had the appropriate recruitment checks completed. This needs to be addressed. There was not a training programme in place at the time of the inspection as there are no permanent staff employed at the home. The Registered Provider’s need to ensure that anyone working at the home has all appropriate training to ensure they are able to meet the needs of the service users in the home. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The home does not have satisfactory self-monitoring systems in place. Staff are not adequately trained in health and safety matters. EVIDENCE: Since the last inspection the Registered Manager has left the home and the Registered Provider’s are now working at the home full time. The Registered Provider said that they had had very limited response to their advertisement for a manager for the home and that they were still trying to recruit a suitable person. The home does not have a quality assurance system in place for monitoring the systems within the home. This needs to be developed. The Registered Provider said that he will develop a quality assurance system for the home. The health and safety servicing and maintenance records were viewed. These were generally up to date and in order. However, the fridge and freezer temperatures in the home were still not being monitored. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 19 Appropriate procedures were in place for accident reporting. Staff working at the home need to complete mandatory training to ensure the safety of staff and service users. Work practice risk assessments for the home had been carried out. These were comprehensive and covered a wide range of situations. Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 3 3 2 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 2 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Athelstan House Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 3 x DS0000051552.V262970.R01.S.doc Version 5.0 Page 21 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 2 Standard YA7 YA14 Timescale for action 12(2) Information regarding advocacy 01/02/06 services must be available in the home. 16(2)(m)(n) The home must provide varied 01/02/06 and appropriate social and leisure activities for service users. Schedule 4 A record of food provided for 13/12/05 13 service users must be maintained. 13(2) Medication administration 13/12/05 record sheets must be signed by the person administering the medication 13(2) The receipt and disposal of all 13/12/05 medication in the home must be accuratley recorded. 23(2)(n) An assessment of the home 01/03/06 must be carried out by an appropriately trained person to ensure the home has appropriate aids and equipment in place. 19(1)(b) All of the information outlined 01/02/06 in Schedule 2 of the Care Homes Regulations must be obtained for all staff working at the home. 18(1) Appropriate training must be 01/03/06 provided to ensure staff have DS0000051552.V262970.R01.S.doc Version 5.0 Page 22 Regulation Requirement 3 4 YA17 YA20 5 6 YA20 YA29 7 YA34 8 YA35 Athelstan House the appropriate skills to carry out their duties. (Timescale of 1/10/05 not complied with) 9 10 YA37 YA39 8 24(1) Appropriate management arrangements must be made for the home. A quality assurance system must be developed for the home. (Timescale of 1/12/05 not complied with) 01/04/06 01/03/05 11 YA42 13(3) Fridge and freezer temperatures must be monitored as required. 01/01/06 (Timescale of 1/08/05 not complied with) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Athelstan House DS0000051552.V262970.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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. 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