Inspection on 12/06/07 for Hall Road

This inspection was carried out on 12th June 2007.

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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hall Road 12/06/08

Hall Road 26/06/06

Hall Road 30/11/05

Hall Road 10/05/05

Hall Road 10/02/05

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 Hall Road 7 Hall Road Wallington Surrey SM6 0RT Lead Inspector Emma Dove Key Unannounced Inspection 12th and 15th June 2007 11:00 Hall Road DS0000060793.V340961.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 Hall Road DS0000060793.V340961.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. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hall Road Address 7 Hall Road Wallington Surrey SM6 0RT 020 8254 9895 020 8669 1288 hall@independencehomes.co.uk 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) Independence Homes Limited Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th June 2006 Brief Description of the Service: 7 Hall Road is a registered care home for up to seven people with learning disabilities, specialising in providing a service to people who also have epilepsy. Seven people are currently living there. Hall Road is a large, detached house situated in a residential road in Wallington, fairly close to local shops and public transport links. The home is owned and managed by a private organisation, Independence Homes limited, who have three other similar services in the local area. Accommodation is provided over two floors. Three single bedrooms, a lounge, dining room, assisted bathroom and staff office are on the ground floor. The remaining four bedrooms, an assisted bathroom and a soft room are on the first floor. A further office and meeting room are on the second floor, which is not accessible to residents. A garden is accessed through the lounge and has a swing, summerhouse and trampoline. The ground and first floor are served by a lift. Staff have access to a car, which enables people to get out in the community. The current fees are from £2,700 to £3,500, depending on the level of support individuals require. Inspection reports and details of the CSCI are available. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over seven and a half hours on the 12th June and three and a half hours on the 15th June 2007. One inspector visited the home and spoke with residents, staff and the temporary manager. Records were looked at and the communal areas and two bedrooms were seen. Questionnaires were sent to relatives and placing social workers. No questionnaires have been received at the time of writing this report. What the service does well: What has improved since the last inspection? What they could do better: Provide a Service Users Guide which is accessible to new and prospective residents. Complete an annual review of care for all residents. All complaints must be recorded, with details of actions taken and the outcome. The staff recruitment process must include checking gaps in employment and references should be addressed to the home for the position staff have applied, rather than ‘to whom it may concern’. Staff must complete training in Picture Exchange Communication System to ensure they can communicate with residents. A permanent manager must be appointed and put forward to register with the CSCI. The hoists and lift must be serviced and checked at the required intervals. The fire alarm must be tested weekly. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 6 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. Hall Road DS0000060793.V340961.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 Hall Road DS0000060793.V340961.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 and 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service has developed a Statement of Purpose, which requires updating. The Service Users Guide details the aims of the service, health, leisure and finances, staff and complaints information. Both documents are provided in standard written format. Admissions are not made until a full assessment has been completed. EVIDENCE: A Statement of Purpose has been developed that includes information about the services provided, the organisation, the aims and objectives of the home. This document must be updated to reflect services currently provided. The Service Users Guide was completed on the 13th June 2007 and includes information to help people decide if it is the right place, however it is all written and consideration should be given to making it more accessible to current and prospective residents. Assessments are in place and include a social history, health information and other details, which is used to develop into a care plan. Assessments are completed by the placing social worker and a representative from the organisation. Hall Road DS0000060793.V340961.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 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 are in place and contain detailed information about peoples care needs and how they should be met. Individuals are supported to make their own decisions and choices. EVIDENCE: Care plans have been developed from assessments and detail people’s needs and how they should be met. The documents are written in the format of ‘I like’ keeping staff focussed on why they work in certain ways with individuals. Care plans include all aspects of personal care, health and medical information, how people communicate, mobility and any assistance required, cultural and religious needs and any behavioural issues. Daily records note activities or therapy people have participated in, any health issues and epileptic activity and any contact with relatives. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 10 Reviews have been held regularly with one exception. The acting manager reported that a date had been made to hold the outstanding review. People were seen exercising choice over activities and meals and were seen to have individual staff support. Risk assessments are in place and are updated when necessary. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 11 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have access to a range of leisure activities and therapies to meet their needs. People are supported to maintain important family relationships. A varied menu is provided, which takes into account any medical, religious or cultural needs. EVIDENCE: People have a varied programme of activities within the home and in the local community. A number of therapists including a speech and language therapist and a physiotherapist, visit individuals during the week. Some people attend a club run by the organisation one day a week. In addition, people go swimming or to the hydrotherapy pool, attend art or music sessions, go cycling, or go on the trampoline. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 12 Staff told the inspector that visitors are welcome. Staff reported that they keep in regular contact with some relatives, with updates on residents health, diet and social activities. Residents are supported to maintain contact with family members and were seen to purchase cards and gifts for ‘fathers day’. Staff said that some residents have regular visits from relatives and they also spend weekends with parents. Two mealtimes were seen, with people supported to eat as required. Staff said that the menu is fairly individualised, to suit peoples dietary needs. A nutritionist is also involved in developing the menu. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. Personal healthcare needs are clearly recorded in care plans, which give details of health needs and any changes. Health needs are monitored and appropriate action is taken. People who use the services have access to healthcare staff at the home and in the community. An appropriate medication policy is accessible to staff, medication records are generally up to date for each resident. EVIDENCE: Staffing levels take into account peoples needs with one to one staffing for most residents during the day. Personal care tasks are detailed in care plans, with some preferences noted. Staff were seen to consider peoples privacy and dignity. Care plans contain good health information, with clear written seizure protocols in place. Staff complete training in epilepsy management and other health related subjects as a part of their induction. Relatives are informed of peoples health and epileptic activity on a regular basis. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 14 Staff were seen to have a good knowledge and understanding of peoples epilepsy and health needs and how to meet them. Appropriate policies and procedures are in place for the administration, recording and storage of medication. Staff complete detailed training in the administration of medication and separate training on the administration of emergency medication, to manage peoples epilepsy. Two gaps were noted in two peoples Medication Administration Record Sheet (MARS), although the medication had gone from the monitored dosage system. One medication did not indicate the date it was opened. Two homeopathic medications had run out and staff reported that they would be replaced, although one had not been used for over twelve days. The systems to check MARS should be reviewed to ensure any gaps are identified. The practice for purchasing homeopathic medications should be reviewed with a system in place to prevent medications running out. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 15 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 adequate. This judgement has been made using available evidence including a visit to this service. An appropriate complaints procedure is in place and made available to residents relatives and placing social workers. Complaints are not always fully recorded. Policies are in place to protect people and residents finances are well managed. EVIDENCE: The complaints procedure is included in the Service Users Guide which is in written format and may not be accessible by residents. No complaints were recorded for 2006/2007, however the acting manager reported that she is dealing with a complaint. The CSCI has not received any complaints, although copies of correspondence between the home and placing social workers indicating concerns have been received in 2007. Appropriate procedures are in place for the protection of vulnerable adults with no issues since the last inspection, although one issue from nine months ago was still being addressed by the local authority. Staff complete training in the protection of vulnerable adults. Some money is held for residents, records seen were up to date and balances correct with good systems in place to checks finances. Hall Road DS0000060793.V340961.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, 25, 26, 27, 28, 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 provides a suitable environment for the specific needs of the people who live there. People who use the service are encouraged to personalise their bedrooms. Communal areas are suitable for people to meet visitors and bedrooms allow people to meet in private. EVIDENCE: Residents have a single bedroom and access to a lounge, dining room, soft room and a fairly large garden. Bedrooms have been personalised to individuals taste and have a bed, wardrobe, storage and space for any specialist equipment. Bedrooms have a monitor so staff can hear if individuals have a seizure and respond appropriately. Care must be taken with these monitors to ensure people’s privacy and dignity is maintained. Residents were seen to be comfortable in their bedrooms. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 17 A notice board on the ground floor contains information about residents routine for the day. A room on the first floor is being developed into a computer room for residents. Residents can spend time relaxing and listening to music in a small ‘sensory’ room on the first floor. Residents can also spend time in the lounge or dining room where they can watch television, listen to music or take part in art and craft activities. The garden has a summerhouse, swing, trampoline and a number of adapted bicycles for individual residents, providing various forms of exercise and activity for people. The second floor has an office and meeting room for staff, which are not accessible to residents. A lift serves to ground and first floor, appropriate ramps have been fitted at the front door and to access the garden. Bathrooms have been adapted to meet residents needs. All areas of the home were clean and hygienic. Appropriate policies and systems are in place for infection control. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 18 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 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff have a range of skills to meet residents needs, however the large number of vacant posts does not always provide consistency of care. Suitable recruitment policies are in place, however some records are not fully in line with regulations. Staff have access to good training and development sessions, however only two staff have completed training in Picture Exchange Communication Systems (PECS), which means staff cannot communicate with all residents. EVIDENCE: The published staffing rota identified six to seven members of staff on duty during the day with two members of staff awake at night. The staffing levels generally enable one to one support for residents during the day, providing adequate support for peoples leisure and social activities and access to the community. Staff files contain application forms, two written references, Criminal Records Bureau (CRB) checks, job description, evidence of the persons identity and a recent photograph. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 19 The recruitment process must include exploring gaps in employment and references must be addressed to the service rather than ‘to whom it may concern’. Also CRB checks must be requested prior to staff starting work at the home. Staff have access to a comprehensive training and development schedule, which includes medical information, medication administration and epilepsy as a part of the induction to the organisation and the service. Only two members of staff have completed training in PECS, which is the communication system used by two residents. All staff must complete this training to ensure they are able to communicate with residents and be able to meet their needs. Supervision records indicated that some staff have not received supervision every other month. Staff said that they are supported. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 20 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. There is no registered manager. Health and safety records are in place and checks up to date, with the exception of the weekly fire alarm test, the hoists and lift service. EVIDENCE: The manager left in February 2007, with temporary arrangements in place until a new manager starts work mid June 2007. This lack of permanent manager has had an effect on working practices at the home, which are being addressed by the organisation. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 21 A representative from the organisation visits each month and checks records, speaks with residents and staff and writes a report on the service. A copy of this report must be sent to the CSCI. A residents meeting was held at the beginning of June 2007 with six residents and six members of staff present. The meeting focussed on residents bedrooms and anything they need for their rooms. Some issues were raised and are currently being addressed. Health and safety records indicated that the electrical supply, gas safety checks have been completed as required. The bath hoist and hoists were due to be checked in December 2006, although records were not available to confirm this check had been completed. The fire alarm was not tested weekly in March or June 2007. It was not clear from records that the lift had been serviced at the required intervals. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 22 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 2 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 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 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 2 X 2 X 3 X X 2 X Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. 3. 4. Standard YA1 YA20 YA22 YA34 Regulation 4&5 13 (2) 22 19 Requirement The Statement of Purpose and Service Users Guide must be up to date. Medication must be signed at the time it is administered. Complaints must be recorded. Staff recruitment practices must include checking gaps in employment and references must be addressed to the person who requested them. Staff must complete training in the Picture Exchange Communication System. A manager must be appointed and register with the CSCI. The fire alarm must be tested weekly, the lift must be serviced at regular intervals and the hoists must be checked at the required times for health and safety reasons. Timescale for action 31/08/07 30/06/07 30/06/07 30/06/07 5. 6. 7. YA35 YA37 YA42 18 (1) c 8 (1) a 13 (4) 31/08/07 31/08/07 30/06/07 Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 24 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. Refer to Standard YA1 Good Practice Recommendations Consideration should be given to the Service Users Guide being accessible to residents. Hall Road DS0000060793.V340961.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. 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