Inspection on 22/11/06 for Athelstan House

This inspection was carried out on 22nd November 2006.

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 7 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 27/04/06

Athelstan House 13/12/05

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 Ms Jean Bovell Key Unannounced Inspection 22nd November 2006 11:15 Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 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.V319851.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th April 2006 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.V319851.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between 11:15 am and 4:30 pm on 22nd November. A Registered Provider, one care support worker and two service users were present. The Inspector was informed by a Registered Provider that the Acting Manager who is also a Registered Provider was attending a meeting at the time of the inspection. During the course of the inspection, the home’s records, documents, policies and procedures were viewed. A tour of the building was undertaken, observations were made and the Inspector spoke to two service users. The requirements that were made at the last inspection and all key Standards were examined. The Inspector received appropriate assistance from a Registered Provider and one care support worker throughout the Inspection. What the service does well: The service users appeared well settled and comfortable within their environment and expressed satisfaction with the standard of care they received. All care plans and risk assessments were appropriately undertaken and indicated that the service users were able to maintain their independence within the supportive environment of the home. Overall, the home was found to be clean, hygienic and well maintained. The atmosphere was calm and homely. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are appropriately assessed prior to admission into the home. A requirement under Standard 2 relating to assessments had been met. EVIDENCE: It was evidenced on service users’ files that needs led assessments that had been undertaken by placing authorities were submitted to the home at the point of referral. The home initiated its own assessment of need by visiting the prospective service user in his/her own environment. Social workers, previous carers, relatives/friends, medical professionals and prospective service users were subsequently involved in the process of assessing the home’s capacity to meet specific needs and aspirations. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 9 Copies of initial needs led assessments which had been carried out by the home was seen within two service users files that were viewed at the time of the inspection. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and assessments of risk are being drawn up satisfactorily. Service users are able maintain their independence and make decisions in relation to their daily living routines. A requirement under Standard 6 relating to periodic reviews of care plans had not been met. EVIDENCE: The care plans of two service users were inspected and it was evidenced that separate personal, healthcare, behavioural and social needs had been identified and that action plans and set goals were put into place. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 11 Risk assessments in relation to specific assessed needs within care plans, such as handling aggressive behaviour, had been undertaken. It was indicated that care plans and risk assessment were being reviewed on an annual basis. The Inspector was informed by a Registered Provider that weekly benefits were paid directly into service users bank accounts and that allowances were safeguarded either by the home or friends. The financial records of one service user were examined and no discrepancies were found. Service users were observed moving freely around the home and those who spoke to the Inspector confirmed that they were able to spend their allowances at will and were free to make decisions regarding activities, meals, what they wore and personal purchases. Information regarding advocacy services in the local community was on display within communal areas at the home. The home’s policy on Confidentiality was in place and a Registered Provider confirmed that service users were able to receive confidential mail, make personal telephone calls and receive visitors in their bedrooms or in communal areas within the home. All bedroom doors were observed to have fitted locks and a Registered Provider reported that service users had been given separate keys. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 12 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, 14, 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. Service users are able to participate in leisure activities of their choice within the home and in the local community. Regular contact with relatives and friends is being encouraged and facilitated. The rights of the service users are being respected and varied and nutritional meals are provided. A requirement under Standard 14 at the last inspection in relation to activities had not been met. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 13 EVIDENCE: It was reflected on records viewed that service users participated in activities within the community such as meals out and shopping. There were regular weekly outings with relatives or friends and one service user attended the temple with a relative each week. There were no indicators that regular outdoor activities were being organised by the home. Service users were observed watching television and/or reading in a small lounge in which smoking was permitted, at the time of the inspection. Contact with relatives and/or friends is encouraged, facilitated and is being maintained. A Registered Provider and a care support worker were observed interacting with service users in a sensitive and respectful manner and knocked on bedroom doors prior to entering. Service users were observed moving freely around home and their personal privacy was respected. The Registered Provider reported that the service users received un-opened mail and were able to make personal telephone calls. Varied and nutritional meals were listed on the menu and a wholesome lunch was provided to the service users at the time of the inspection. Although snacks and drinks were readily available, the service users were allocated individual cupboards in which personal snack/drink choices were being stored. Two service users expressed satisfaction with the quantity and quality of food that was being provided at the home. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 14 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. The service users receive personal support as required and their health care needs are being met appropriately. The policy and procedures on medication are comprehensive but the MAR sheet is not being satisfactorily completed. A requirement under Standard 20 in relation to bottled medication had been met. EVIDENCE: A care support worker confirmed that the service users were basically selfcaring in relation to their personal care routines but may on occasions require prompting or support. They were, however, independent in choosing what they wore each day. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 15 None of the service users experienced physical difficulties and aids or adaptations were not required at the time of the inspection. It was indicated on care plans viewed that service users had allocated GPs and that their separate health care needs were being assessed and met appropriately. The Medication policy and procedures were in place and the storage and disposal of medicines were satisfactory. However, there was no signature in relation to medication that had been administered to service users on the morning of the inspection. The Inspector was informed by a care support worker that none of the service users self-administered their medication. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is satisfactorily detailed and the service users are being adequately protected from abuse. A requirement under Standard 23 relating to the policy and procedures on the protection of vulnerable adults had not been met. A requirement under Standard 23 in relation to training on the protection of vulnerable adults had been complied with. EVIDENCE: The complaints procedure was in place and accessible to the service users and their relatives. It was indicated in the complaints book that no complaints had been made to the home following the last inspection. The policy and procedures relating to the protection of vulnerable adults were not available for viewing at the time of the inspection. The Registered Manager explained that the documents were being updated and held elsewhere. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 17 The records were reflective of accredited training on the protection of vulnerable adults being delivered to a Registered Provider and a care support worker. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 18 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, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, safe and well maintained. A requirement under Standard 24 relating to automatic door closures had been met. A requirement under Standard 29 in relation to an assessment for appropriate aids and adaptations had not been complied with. EVIDENCE: The home is adequately spacious, comfortably furnished and the communal areas are appropriate for shared or individual activity. The garden was tidily Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 19 kept and accessible to the service users. There were no issues in relation to the laundry. Automatic door closures had been fitted on all bedroom doors. There was no documented evidence that an assessment had been carried out to ensure that there were appropriate aids and equipment at the home. Overall the home was found to be clean, hygienic and well maintained. The atmosphere was calm and homely. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 20 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. Care staff members are appropriately trained and qualified for meeting the needs of the service users. The recruitment policies and procedures are satisfactory. Requirements under Standards 34 and 35 in relation to staffing and training had been met. EVIDENCE: It was indicated on training certificates that training delivered to a care support worker during 2006 included protection of vulnerable adults, health and safety, infection control, first aid and manual handling. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 21 A care support worker had also achieved level 2 national vocational qualification in care. The personnel file of one care support worker was viewed and found to contain all the required documents including photo-identification, CRB disclosure certificate, application form and references. A Registered Provider and care support worker who covered duty at the time of the inspection were observed being competent and attentive in meeting the needs of the service users. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 22 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 adequate. This judgement has been made using available evidence including a visit to this service. Requirements under Standards 37 and 39 relating to management and quality assurance have not been met. The health and safety of the service users are being satisfactorily protected. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 23 EVIDENCE: The Inspector was informed by a Registered Provider that the Acting Manager had applied for registration following the last inspection but had not yet received a response. Quality assurance and quality monitoring systems for obtaining the views of service users, relatives and stakeholders were not evidenced at the time of the inspection. The records were indicative of health and safety checks being up to date. These included fire safety, gas maintenance, portable appliances and water temperature. Risk assessments had been undertaken in relation to bathing, hot water and fire. Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 2 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 X 2 X X 3 X Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 25 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 Timescale for action 01/04/07 2 YA14 The service user plan must be periodically reviewed and updated to reflect any changes. Previous timescale 01/06/06. 16(2)(m)(n) The home must provide varied and appropriate social and leisure activities for service users. (previous timescale 01/02/06 and 01/06/06 not met) The Registered Person must ensure that signatures are entered against administered medication on MAR sheets. The home’s guidelines for the Protection of Vulnerable Adults must be updated in conjunction with “no secrets” and dovetail with the Hounslow’s MultiAgency Adult Protection documentation. Previous timescale 01/07/06. An assessment of the home must be carried out by an appropriately trained person to ensure the home has appropriate aids and equipment in place. (previous timescale DS0000051552.V319851.R01.S.doc 01/04/07 3 YA20 17(3)(a) 20/12/06 4 YA23 13(6) 01/04/07 5 YA29 23(2)(n) 01/04/07 Athelstan House Version 5.2 Page 26 01/03/06 and 01/07/06 not met) 6 YA37 8 Appropriate management arrangements must be made for the home. (Previous timescale 01/04/06 and 01/08/06 not met) A quality assurance system must be developed for the home. (Previous timescales of 1/12/05, 01/03/06 and 01/08/06 not complied with) 01/04/07 7 YA39 24(1) 01/04/07 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.V319851.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Athelstan House DS0000051552.V319851.R01.S.doc Version 5.2 Page 28 - 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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