Inspection on 24/10/06 for Hagden Lane (336-338)

This inspection was carried out on 24th October 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hagden Lane (336-338) 13/10/08

Hagden Lane (336-338) 26/10/05

Hagden Lane (336-338) 11/01/05

Hagden Lane (336-338) 17/08/04

Hagden Lane (336-338) 04/03/04

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Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

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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 Hagden Lane (336-338) 336-338 Hagden Lane Watford Hertfordshire WD18 7SH Lead Inspector Mrs Sheila Knopp Unannounced Inspection 24th & 28th October & 22nd November 2006 11:00 Hagden Lane (336-338) DS0000019401.V317196.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 Hagden Lane (336-338) DS0000019401.V317196.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. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hagden Lane (336-338) Address 336-338 Hagden Lane Watford Hertfordshire WD18 7SH 01923 213 015 01923 218 416 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) www.turning-point.co.uk Turning Point Southern Area Office Mrs L Harris Care Home 6 Category(ies) of Learning disability (6), Mental disorder, registration, with number excluding learning disability or dementia (6) of places Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 6 people with a learning disability or mental disorder (when associated with learning disability). 26th October 2005 Date of last inspection Brief Description of the Service: Numbers 336 & 338 Hagden Lane form a residential home for six service users with learning disability/mental disorder excluding dementia run by Turning Point. The service user groups are separated by gender with three male service users at No. 336 and three female service users at No. 338. The building consists of two semi-detached, three bedroom houses situated in a residential area in the town of Watford. It is within easy reach of the shopping centre, public park and leisure facilities. Public transportation is walking distance away. There is no parking space except on the main road. Each of the two houses has a patio that leads into the back garden. At the end of the two gardens are the garages, one of which has been converted into an additional office (No. 338) and the other, an activity room (No.336). All the bedrooms are on the top floor, except for one at ground floor level at No 336.The kitchen/diner is fairly large. The bathrooms and toilet facilities are adequate for the number of service users living in the home. There is access between the two houses via the front and back doors. The home has adequate communal spaces in both houses. The main administrative office is at No. 336. The Service User Guide, which provides information about the home, can be obtained from the manager. The current service user contribution to fees where applicable is £62.34 per week. Placements at 336 & 338 Hagden Lane are block funded by Hertfordshire County Council. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over three visits the first of which was unannounced. The second visit took place on a Saturday afternoon to meet service users and receive their completed questionnaires. A further meeting was arranged with the manager to review confidential records, which were not accessible to the staff on duty at the time of the first visit. Key standards were inspected. The information in this report is based on discussions with 4 service users and staff on duty. Service users showed the inspector around the houses in which they live. Relevant care, personnel and health & safety records were reviewed as well as information received about this service between inspections. Five service users completed questionnaires and where required were assisted by staff at their day care setting so that an independent view was provided. Questionnaires were sent to social workers and community psychiatric nurses involved with service users. No concerns have been raised directly with the Commission regarding the standard of service provided. This is the second key inspection where no requirements have been made under the Care Homes Regulations 2001. What the service does well: What has improved since the last inspection? Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 6 The houses continue to be well maintained and decorated with new items purchased as needs arise. New kitchen units are due to be fitted in number 338. The information provided to the Commission regarding incidents affecting individual service users has improved as staff are now telling us about the follow up action they are taking to put things right. 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. Hagden Lane (336-338) DS0000019401.V317196.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 Hagden Lane (336-338) DS0000019401.V317196.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): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents are provided with a tenancy agreement; this sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. This gives a clear understanding of what residents can expect. The agreement is regularly reviewed with service users. Admissions are not made to the home until a full needs assessment has been carried out. The assessment involves key people in the life of the service user. Details of the assessments made by other health & social care professionals are available. EVIDENCE: The service users confirmed they were involved in the decision to move into the houses at Hagden Lane. One person said “I liked it when I saw it” Another person confirmed they visited on three occasions and met some of the other residents “who said I would like it there”. Each resident receives a ‘People in Partnership Pack’, which includes details of the services provided and the rights of service users in pictorial form. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved in developing and reviewing their care plans and risk assessments so they are aware of plans to promote independence and responsibility and any possible restrictions or constraints placed on their every day lives. EVIDENCE: Each service user has a detailed plan of care, which is regularly reviewed and updated. The inspector reviewed specific plans in relation to incidents that had been reported to the Commission and found good accounts of the multidisciplinary reviews that had taken place to discuss the health & welfare of the individual. There was evidence that service users are involved in agreeing and signing their care plans and agreeing strategies to change behaviour. The risk assessments seen were balanced between the need to promote an independent life style but also to protect the individual service user. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 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 involved in a range of employment, recreational and learning activities within the community, which support their personal development. Service users are supported in maintaining contact with family and friends. Service users rights to make decisions in their every day lives is supported and understood by staff. Service users are fully involved in planning, shopping and cooking their meals. EVIDENCE: A service user commented on the help provided by staff to develop their independence. Service users are aware of the role of staff in supporting them to move on to more independent accommodation at some stage and recognise Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 11 that the domestic routines within the home and planning, shopping and preparing meals is all part of this. Each service user has a weekly budget for food shopping and plans their weekly menu with support from staff. The dietary needs of service users has up to know been closely monitored by the Community Dieticians. This service has now been withdrawn. The manager is aware of the need to put alternative arrangements in place to ensure staff can demonstrate service users are eating a healthy and nutritious diet. Staff are provided to support social activities. One service users said ‘”When I am not at the day care centres I am allowed to choose what I would like to do”. At the time of the inspection the inspector was aware of staff taking a service user to Bruges for the day. A service user showed the inspector pictures of a recent holiday and preparations were being made to attend a disco in London. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive the care and support they require from staff as agreed in their care plan. Service users physical and emotional health needs are met with the support of a range of health & social care professionals. Medicines are administered by staff in accordance with the correct procedures. There are systems in place for service users to take their own medication subject to risk assessment and regular monitoring. EVIDENCE: The review of care records demonstrated the involvement of a range of community health & social care professionals. Service users access local health services and their health is regularly monitored. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 13 Staff are available to support service users and monitor any changes in their well being if the need arises, but the emphasis is on service users organising their daily routines and own personal care. There are suitable systems in place for ordering, storing and administering medication according to the policies in place. Regular audits are carried out to check stock levels. The dispensing pharmacist visits to provide advice and support. The records indicate medication is regularly reviewed. There are procedures in place to assess and monitor the suitability of service users to give their own medication. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel that their views are listened to and that they receive support from staff they trust. EVIDENCE: A service user said ‘”I always speak to the staff and my key worker and the manager when I am not happy in the house where I live”. Another service user said “If the problem can be solved the staff are always ready to listen”. There is a clear and robust complaints procedure in place. No complaints have been received from service users, relatives or other health & social care professionals regarding the service provided at Hagden Lane between inspections. Service users are reminded of their rights and how to make complaints when the Tenancy agreement is reviewed. Comment books are also available in each house and used to varying degrees by individual service users. Resident meetings are held and minutes kept. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 15 Regular contact with key workers, day centre staff and staff from the community learning disability and mental health teams also provide service users with avenues to express any concerns. Three service users attend a monthly advocacy group. The records of one service user included a signed agreement that had been reached between themselves and staff as to how they wanted to be approached when they came home in the evening. Staff receive regular updating in Safe Guarding Adult procedures and are aware of their responsibilities to report any concerns. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 16 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Both houses provide services users with a safe comfortable, domestic style environment in which they can develop their independence. EVIDENCE: Each three bedroom house is well maintained with comfortable furnishings and fittings. Standards are maintained through an on-going programme of refurbishment and replacement of damaged items. The two service users who showed the inspectors their rooms were happy with the arrangements and had added their own personal effects and belongings. Each house has a laundry area for residents to do their washing. Staff have had access to infection control training. The gardens of each house are well maintained and have seating and covered smoking areas. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are supported and supervised by well-trained staff. The required checks are carried out on new staff before they start work to make sure that suitable people are employed. EVIDENCE: The comments from service users indicate they know who their key worker is. One service user said “I get on well with my key worker”. Another person said the staff are “always very nice and kind to me”. Over 50 of staff have qualifications at NVQ level 2 or above. Each member of staff has a training record and the manager has a training matrix to identify the timescales for training updates and whether there are any gaps in the skills of the staff team. Training includes the management of challenging behaviour. New staff complete the Turning Point Induction Programme. Staff receive equality and diversity training. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 18 The regulation 37 notifications received by the Commission indicate when incidents occur the residents have fluctuating needs in terms of their emotional and mental health problems. The manager is aware of the need to monitor incidents in relation to the approach of individual staff to specific situations to see whether a different approach could have changed the eventual outcome or whether further training and support is required. Staff confirmed that they felt supported. The staff interviewed confirmed they felt supported and confirmed they were able to raise any concerns as part of the supervision process. They also have access to a confidential care line. The records seen indicate staff are receiving regular supervision. An agency staff member reported they had received an induction to the home. Staff did not raise any concerns regarding care practices. The recruitment files seen confirmed that the required information including Criminal Records Bureau clearance is obtained before staff have contact with service users. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by the current manager and closely monitored by Turning Point to ensure that the home is organised and run for the benefit of the service users. Regular safety checks are carried out to ensure that the health & safety of service users and staff is protected EVIDENCE: One service user said the manager was ‘easy to talk to and I trust her’. Turning Point has quality assurance systems in place to monitor standards, which include obtaining the views of service users. The audits include health & Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 20 safety, monitoring of accidents and incidents, resident finances and the premises. Monthly reports from a representative of the provider were available providing evidence that regular checks are carried out on the required areas. The area manager monitors and supervises the homes’ manger setting targets and goals against the provider’s policies and procedures. Service users attended a fire safety course with the staff and have been involved in a recent drill. Regular checks of fire safety equipment and alarm checks are recorded. There has been a recent visit by the Hertfordshire Fire Safety service following which the sprinkler system was extended. Staff have received first aid and food hygiene training. Accident and incident forms are completed and monitored by the provider. Information to the Commission under Regulation 37 is now more concise with details of the follow up action taken. Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 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 Standard No Score 1 3 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 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No previous requirements made 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. Standard Regulation Requirement Timescale for action 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 Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hertfordshire Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Hagden Lane (336-338) DS0000019401.V317196.R01.S.doc Version 5.2 Page 24 - 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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