Inspection on 04/05/05 for Hainault

This inspection was carried out on 4th May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hainault 11/11/08

Hainault 18/12/07

Hainault 16/11/06

Hainault 09/09/05

Hainault 07/09/04

Hainault 11/05/04

Similar services:

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Hainault 35 Lesney Park Road Erith Kent DA8 3DQ Lead Inspector Elizabeth Brunton Unannounced 4 May 2005 10:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hainault Address 35 Lesney Park Road Erith Kent DA8 3DQ 01622 769 100 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.mcch.co.uk MCCH Society Ltd Mrs Rita Fitton Care Home 14 Category(ies) of The home is registered to provide registration, with number accommodation and care for up to fourteen of places service users who may have a learning disability, a physical disability and/or sensory impairment. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7 September 2004 Brief Description of the Service: Hainault is a care home, which provides care for fourteen adults with learning disabilities. The home has been open since October 1988 and is operated by Maidstone Community Care Housing Ltd (MCCH). Hainault is a large, old, detached building on two floors, with a large, rear garden. There is no lift. The house is divided into three flats. Flat 1 accommodates two people and flats 2 and 3 can both accommodate six people. However, it had been decided by MCCH, that only five service users would live in flat 2, due to the limited space and shared bedrooms in that flat. All service users now have single bedrooms, apart from two service users who share a room in flat 2. All bedrooms have washbasins and three rooms have en-suite facilities. Each flat has a lounge, kitchen, bathroom and toilet(s). Flat 3 has very spacious communal rooms. There is also an office and a small sensory room on the ground floor. There were thirteen service users staying in the home on the day of inspection and no vacancies. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10.30am. The inspector was in the home for seven hours. Five service users were spoken to separately. It was not possible to find out the views of some service users, because of communication issues. Staff were also spoken to, including the manager and three of the care staff who were on duty during the day. All of the communal rooms, the garden and some service users’ bedrooms were seen. Records were looked at, together with four service users’ individual case files. What the service does well: What has improved since the last inspection? The home was almost fully staffed and there were now two waking staff on duty each night, rather than one staff for the whole building, as before. Extra staff came on duty at weekends, which meant that service users had been able to go out for the day, to the seaside and other interesting local places. A service user had moved from flat 2 to another home and the service user who used to share a room with him, now had his own room. This was much better for him. Service users in flat 2 said there was more space for everyone in the flat, now that there were five people living there, instead of six. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,4 & 5 Introductory visits to the home had helped a newly resident service user to settle into the home. Information about him had enabled staff to provide the care and support needed. A service users’ guide and contracts are needed, in order to give service users full information about the services provided in the home. EVIDENCE: A service user had recently moved into the home from the community. He had visited and stayed overnight before moving in. Staff said that that this service user had settled quickly into the home and that his family had been very relieved about this. Assessment information had been provided by Bexley Social Services Learning Disability Team and by the local day centre. Staff said that this information about the service user’s needs, likes and dislikes, had helped them to provide the care and support needed. The home had a statement of purpose and the manager had started work on developing a service users’ guide. This will provide prospective resident service users with more information about Hainault. Comprehensive contracts for service users were still needed. Service users and their relatives or representatives needed clear information about the terms and conditions of residence at Hainault. (see requirement 1) Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 & 8 Service users had participated in regular individual planning meetings, where goals for developing service user’s lives had been set. Service users had made decisions and choices about their lives and must receive all necessary support in making their views known about the future of Hainault. EVIDENCE: Individual planning meetings had been held with service users and their relatives twice a year. One service user said that she had set the goals at her last meeting and was pleased that these had already been met. Service users said they decided whether they wanted to attend day centres, join in outings and other activities and that they helped to plan the menu in each flat. Two service users said they had been fully involved in choosing accommodation to move on to, where they could have greater independence. They said they had been encouraged and supported by staff in becoming more independent. Service users and their relatives and advocates were currently being consulted about the future of Hainault. It is important that those service users who do not have an active and involved relative or an advocate, who can support them in making their views known about this important issue, are provided with this service as soon as possible. (see requirement 2) Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 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 standard(s) 15 & 17 Staff supported service users in maintaining contact with relatives and friends. Varied and nutritious meals were served and mealtimes were pleasant occasions. EVIDENCE: Most service users had contact with relatives and some people visited their families regularly at weekends. Service users said they had been helped by staff in writing letters and making contact with relatives and friends. One service user was using the telephone in his flat to phone his relatives. He said that he had friends to visit and cooked meals for them in his flat. Some service users were friends with others in the home and some spent time visiting service users, having meals and joining in activities in other flats. Service users said they liked the food and had helped to plan the menus in each flat. Those menus seen, showed that varied and nutritious meals had been served. One of the service users in flat 1 had cooked the evening meal for himself and his flat mate, with some assistance from staff. The evening meal in flat 3 was a relaxed and sociable affair. Staff sat with service users and gave the necessary assistance in a sensitive manner. Staff said they were Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 11 helped in this by the written guidelines in place. Service users had been weighed each month and some service users had been supported in following diets to either gain or lose weight. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 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 standard(s) 19 & 20 Healthcare needs were well recorded and met. Medication was safely stored and properly administered. EVIDENCE: Information about service user’s health care needs was seen on file. Service users said they attended the doctor, hospital, dentist and optician when necessary and that staff supported them in this. The outcomes of these appointments were recorded on file and health care needs had been discussed at service users’ individual planning meetings. Medication was safely stored in all three flats. Medication and medication records were inspected in flat 3, where medication had been properly administered. One service user administered some of her own medication and a risk assessment of this activity had been undertaken. The service user said that she kept the medication safely in her room. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Some service users knew how to complain and complaints had been properly dealt with, though some additional recording was needed. The aggressive behaviour of one service user was placing others at risk and a more suitable, alternative placement needed to be found for her, without delay. EVIDENCE: Some service users said they would know how to make a complaint, if they needed to and that they thought it would be properly looked into by the manager. However, it would be difficult for other service users to make a complaint, given their limited communication. One relative had complained on two occasions since the last inspection. The manager had dealt with these complaints and had taken the necessary action. This had not been fully recorded for one of the complaints. The aggressive behaviour of one service user in flat 3 had continued to place other service users and staff at risk. One service user said she was glad to be leaving Hainault because of her. There had been a number of incidents, where this service user had pulled other service users’ hair and had assaulted staff. Incidents had been recorded and the CSCI notified. This matter was raised with MCCH in a letter from the CSCI in March 2005. All possible steps were being taken by staff to protect other service users and an alternative placement was actively being sought for the service user in question. Staff were also concerned about a service user in flat 2, who had gone missing from the home or day centre, on several occasions, thereby placing himself at risk. Those involved had attended a risk meeting and the necessary measures had been put in place. A copy of this information needed to be retained on the service user’s file, so that it was available to staff on duty in flat 2. There Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 14 had been no other adult protection concerns or allegations, since the last inspection. Staff were aware of the importance of safe caring and of safeguarding service users from harm. (see requirements 3 & 4 and recommendation 1) Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 The home was spacious, comfortable and well maintained. The heating system, some carpeting and unpleasant odours needed attention, in order to increase the comfort of service users. EVIDENCE: Service users and staff said they liked the building and that it was comfortable and spacious. Bedrooms were well decorated and furnished and service users were pleased with them. Service users in flat 2 said that they had more space, now that there were five people living in the flat, instead of six. One service user had recently moved from a double to a single room. He was now able to have more of his belongings around him Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 16 in the room and could sleep later in the mornings. The carpet in one bedroom in flat 3 was very stained. Joins in the lounge carpet in flat 2 made it unsafe and it needed replacement. The manager said that she was unable to replace this, as Hainault’s budget for the current year had not yet been set. The garden also needed attention. The home was clean and staff had worked hard to prevent offensive odours. However, further measures were required in the activity room in flat 3. Service users and staff complained about the heating system and the fact that the home became unbearably hot, at times, when the heating was on and especially in flat 1. The overall level of heating provided could not be regulated in line with the weather and the output from individual radiators could not be adjusted. (see requirements 5, 6 & 7 and recommendation 2) Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 34 The home was adequately staffed by an able staff group and vacant posts were being recruited to. Staff had been properly recruited and the necessary checks made. EVIDENCE: Services users and staff thought that there were enough staff on duty at any time and were pleased that the number of waking night staff had been increased to two. Additional staff were rostered on duty at weekends, which meant that service users were regularly taken to the seaside and other places of interest. Service users said that staff were kind and helpful and treated them with respect. The home was nearly fully staffed. Three new staff had recently been appointed and were waiting to start work. The manager was currently recruiting to the two vacant posts. However, two further staff were about to resign and the manager was concerned that the uncertainty over the home’s future could inevitably lead to further staff leaving. Service users will need the support of a stable and experienced staff group in order to manage the changes, which may lie ahead. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 18 Those recruitment records retained in the home showed that staff had been properly recruited and checked before starting work. There were no records for one member of staff and photographs of two other staff were required. (see requirements 8 & 9) Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 42 The home was well managed and service users were protected from the risk of fire. EVIDENCE: The manager was qualified and experienced and had managed the home for several years. She was well supported by an able deputy. Service users and staff said that the home was well managed and staff said they were supported in their work. The building appeared to be safe and no hazards or risks to the safety of service users were seen. Fire equipment had been regularly tested and checked and fire drills had been regularly held. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 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 2 3 x 3 1 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hainault Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 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. Standard 5 Regulation 5(1) Requirement Service users must be provided with comprehensive contracts/statements of the tems and conditions of their residence in the home. (Previous timescale of 1/12/04 not met) Service users, who do not have an active and involved relative or an advocate, must be provided with independent support support them in making their views known about the future of the home. Service users must be protected from harm caused by other service users. Risk assesment information concerning the service user in flat 2 going missing from the home must be made available to staff on duty in that flat. The garden must be properly maintained. (Previous timescale of 1/11/04 not met) The carpet in the lounge in flat 2 must be replaced/made safe for service users. All parts of the home must be maintained at a comfortable temperature. Timescale for action 1 August 2005 2. 8 12(2) 1 August 2005 3. 4. 23 23 12(1) 12(1) 1 June 2005 9 May 2005 5. 6. 7. 24 24 24 23(2) 16(2) 23(2) 1 June 2005 1 June 2005 1 September 2005 Page 22 Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 8. 9. 34 34 16(2) 17(2) The home must be kept free of offensive odours. Those staff recruitment records listed under schedules 2 & 4 to the regulations, must be retained. (Previous timescale of 1/11/04 not met) 1 June 2005 1 July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 22 24 Good Practice Recommendations Complaint investigations and outcomes must be fully recorded. The carpet in one of the bedrooms in flat 3 must be cleaned/replaced. Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection River House 1 Maidstone Road Sidcup Kent, DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hainault G51 G01 S38196 Hainault V212496 040505 Stage 4.doc Version 1.30 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. 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. 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