Inspection on 30/11/05 for Hall Road

This inspection was carried out on 30th November 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 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 12/06/07

Hall Road 26/06/06

Hall Road 10/05/05

Hall Road 10/02/05

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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 Hall Road 7 Hall Road Wallington Surrey SM6 0RT Lead Inspector Deborah Yapicioz Unannounced Inspection 30th November 2005 08:50 Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 Susan Jane Parish Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Bedroom 7 is for the use of a service user in a wheel chair only. Date of last inspection 10th May 2005 Brief Description of the Service: 7 Hall Road is a large, detached house situated in a residential road in Wallington, fairly close to local shops and local transport links. Hall Road is registered with the Commission for Social Care Inspection to offer care and support to service users between the ages of 18-65 with epilepsy and severe learning disabilities. The home opened in July 2004. The registered provider is Independence Homes limited. Care and accommodation is provided on the ground and first floors with the second floor providing office space and staff facilities. The home also has a garden to the rear of the property. The home has their own transport in the form of one wheel chair accessible vehicle and another standard vehicle. The registered providers have installed a lift and other environmental adaptations to ensure the home meets the needs of the service users Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second inspection for the year 2005/6. The inspection was unannounced and took place in the morning of 30th November. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. Ms Parish is in the process of working through her notice. Karen Walker will cover the manager role at the home in the short term. The post of manager has been advertised and interviews have taken place. The inspection was spent meeting with Susan Parish and Karen Walker, looking at records, observing staff and service users and a tour of the premises. The inspector would like to thank the service users and the staff team for their help in facilitating the inspection. What the service does well: What has improved since the last inspection? What they could do better: Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 6 The home has one outstanding requirement from the previous inspection. The service users contracts were not available at the time of the inspection as they are held at “Independence Homes” head office. A copy of the service users Contracts should be held on service users files at the home. 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. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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.V268339.R01.S.doc Version 5.0 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 the following standard(s): 1,2,5, The home provides information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. EVIDENCE: The home has a statement of purpose and a service users guide. Although there have been no new service users since the last inspection the home has a procedure for introducing service users to a new residential placement, which includes the homes, own assessment process and introductory visits. New Service users must also have a full assessment of their needs; compiled by their care manager or other relevant person. All of the present service users have assessments on file. Any new service users to the home will only be considered once compatibility with the current service users is established. The service users contracts were not available at the time of the inspection as they are held at “Independence Homes” head office. A copy of the service users Contracts should be held on service users files at the home. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 the following standard(s): 6,9 The service users have comprehensive individual care plans with detailed information on their needs and personal goals. Individual care plans include consultation with service users and are regularly updated by the key-worker to reflect current needs. EVIDENCE: Each of the service users has an individual tailored care plan, known as Fundamental Care Plans. The care plans are on the service users file and is a record of their aims and goals as well as their achievements. These plans cover all aspects of care, such as the client’s physical skills, their communication ability, self-care skills, health, behavioural issues and community living skills. Information is also available in respect of service users’ preferred likes and dislikes and any dietary needs. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 10 The service users at the home have limited communication skills and the home manager stated that the staff team have built up a good relationship with the residents and use that knowledge to advocate on their behalf. The home manager explained that the home has introduced more communication aids since the last inspection. The service users have a six monthly in house review and an annual multidisciplinary meeting. The home operates a risk management system and individual assessments are on service users files. Copies of individual risk assessments are kept on the service users file. There are also risk assessments relating to the environment and staff under the health and safety at work act. Risk assessments are reviewed regularly. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,13,15,17 The service users at the home are offered the opportunity to engage in age appropriate activities with an emphasis on using community based facilities although this is limited by the type of vehicle used by the home. The daily routines and house rules promote residents’ rights and encourage independence as far as possible. EVIDENCE: It is part of the role of the staff team to encourage service users at the home to maintain and develop independent living skills. The service users have a weekly activity timetable and details of the service users weekly commitments are also recorded on service users files. Activities are provided on a one to one basis. The staff team work with the service user group on a rotation basis. There is a strong emphasis on service users using the community and the home has two vehicles. One of the vehicles is wheelchair accessible. The service users also have a bus pass. The home employs ten therapists who work alongside the staff team at the home to devise individual programmes for the service users. These include a speech and language therapist, occupational therapist, music therapist, reflexologist, complimentary therapist, physiotherapist, nutritional therapist, drama therapist and a psychologist. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 12 A massage therapist has recently stated working at the home. The maaage therapist works alongside the physiotherapist On the morning of the inspection the music therapist was working with service users in the home. Many of the service users at the home have particular dietary needs such as “gluten free” or “dairy free” meals. A nutritional therapist works along side the cook to provide a balanced diet that takes into account the various needs of each individual service users at the home. For example the cook makes her own tomato ketchup and mayonnaise, which takes into account the service user allergies. There has been a change to the nutrional therapist since the last inspection. The nutritional therapist employed by the home “agrees” the menus with the cook. They are very detailed and include preparation details for each meal so that any food intolerances are taken into account. A record is kept of what each service user has eaten. Some of the service users also take food supplements, which are prescribed after detailed background information and relevant information has been gathered. This exceeds standard 17. The home has an open visitors policy and the home just ask that visitors phone to ensure their family member is going to be in before they visit. Family members can also phone to speak to the home manager or the key worker if they wish. Relatives are invited to social events held at the home as well as reviews. Service users can be visited in any of the homes communal areas as well as the service users bedrooms. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical and emotional health needs are detailed in personal plans to offer consistent care in this area. Residents’ medication is well managed to ensure good health. EVIDENCE: The service users at the home all need a high level of support with their personal care. Personal care is provided in private, and timings of this are also flexible. The home provides consistency and continuity through designated key workers All service users are registered with a local General Practitioner. The staff team at the home monitor the health of each of the service users and would ensure they receive any treatment needed. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 14 The home has a policy on the receipt, recording, storage, handling, administration and disposal of medication. It is the homes policy that all medicines administered are recorded on Medicine Administration Record Sheets. The home uses a “nomad” system for medications. All medication records were complete at the time of the inspection. As part of their induction staff at the home attend a “familiarisation” course, which includes medication training. All of the staff team are trained in the administration of rectal Diazepam. The local pharmacist carries out regular audits and a written report of the visits were available during the inspection. The home manager stated that the home and pharmacy have established a good relationship, which she felt benefits the service users at the home. Records examined showed that all medicines administered are recorded on Medicine Administration Record Sheets, which were up to date at the time of the unannounced inspection. The home also uses a medication “prompt” board, which means staff are able to see at a glance that all service users have had their medication. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 There is a complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The complaints procedure was clear and contained all of the elements required to meet standard 22 including a minimum response time of less than 28 days. The home has a copy of the local authority Adult Protection Policy on site and the staff team receive training on these issues. Since the last inspection the home manager has completed a training course on the London Borough of Sutton Adult protection policy and procedures. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,30 The general décor of the home is good providing a comfortable, clean and safe environment for service users to live in. Service user’s bedrooms provide privacy and reflect individual interests and preferences. EVIDENCE: 7 Hall Road is a large, detached house situated in a residential road in Wallington, fairly close to local shops and local transport links. Care and accommodation is provided on the ground and first floors with the second floor providing office space and staff facilities. The registered provider has replaced the carpet in the communal lounge sine the last inspection. The top floor landing has been redecorated and the home manage informed the inspector that she has ordered, “kick boards” for the doors. The home has several people who use wheelchairs so the “wear and tear” can be quite heavy. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 17 All seven bedrooms meet the minimum standards with regards to size six bedrooms have ensuites, which consists of toilets and wash hand basins. One bedroom does not have an ensuite. It is a condition of registration that this bedroom is only used by wheelchair user (where a normal sized ensuite would not be suitable). A disabled toilet and bathroom are close to the bedroom just along the corridor. There is also a Parker bath on the first floor and a bath with a bath lift on the ground floor. Each of the service users bedrooms has been individualised according to their interests. For example one of the service users supports a premier league football club and the club “logo” has been pained on his wall. The registered providers have installed a lift and other environmental adaptations such as ramp to the front and back doors as well as hoists, to ensure the home meets the needs of the service users. The premises were generally bright, airy and clean on the day of the unannounced inspection. The home has a heath and safety policy in place which includes specific policies covering the disposal of clinical waste, control of infection, use of cleaning materials, storage and preparation of food, use of protective clothing and dealing with spillages. There is a Control of Substances Hazardous to Health cupboard. Health and safety law posters were on display in the home. The homes washing machine was capable of thoroughly cleaning foul laundry at appropriate temperatures (minimum of 65 Degrees Celsius). Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35, The staff team at the home have a range of skills and ability, which appear to meet the needs of the service users. The staff team have all had Criminal Records Check, as a safeguard to offer protection to the homes service users. EVIDENCE: The staff job descriptions were comprehensive in there content and linked to achieving service users goals. The home offers training opportunities to staff at all levels within the home. New members of staff complete an induction programme covering various subjects including health and safety, fire drills, epilepsy and medication. The staff team have also been able to access a number of other training courses during the past year including first aid, manual handling and medication. The home has regular staff meetings Criminal Records Checks are completed before a new member of staff can begin work. Staffing is provided on a one to one basis and the staff members are allocated to a service user at the handover meetings. There are two staff members on duty each night. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,42,43 There are clear lines of accountability within the home, which is aimed at ensuring the well being of the service users. In the main health and safety arrangements are adequate to ensure potential risks to service users health and safety are so far as reasonably possible identified and minimised. EVIDENCE: Ms Susan Parish currently manages 7 Hall Road. She has been in operational day-to-day control of the home since the home opened and was also involved in the registration process. Ms Parish is in the process of working through her notice and the unannounced inspection took place on her last day of duty. Karen Walker will cover the manager role at the home in the short term. The post of manager has been advertised and interviews have taken place. Ms Parish and Ms Walker have been able to have a handover period to ensure there is as little disruption as possible to the running of the home. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 20 Records required for the safety and well being of service users are in place including accidents, water temperatures, complaints, incidents, food records, fire records, staff and service users case files, medication records and so forth. A first aid box and a fire blanket are situated in the kitchen. There are fire extinguishers throughout the house. Coloured chopping boards and knives were seen in the kitchen. All staff must attend training relating to health and safety issues including fire safety and medication training. A record of training attended is kept on staff files. The home has recently introduced a new system to help with staff time management and planning staff rotas. A representative of the registered provider visits the home regularly and copies of the visit report are sent to the Commission for Social Care Inspection Corydon office. Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 2 X X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hall Road Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 3 DS0000060793.V268339.R01.S.doc Version 5.0 Page 22 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 YA5 Regulation 12(5) Requirement A copy of the service users contracts must be kept on their file. Outstanding from 31.10.05 Timescale for action 31/03/06 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 Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Hall Road DS0000060793.V268339.R01.S.doc Version 5.0 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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