Inspection on 17/05/06 for Hamilton House

This inspection was carried out on 17th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hamilton House 11/06/09

Hamilton House 12/07/07

Hamilton House 08/02/06

Hamilton House 04/10/05

Hamilton House 30/01/05

Hamilton House 07/10/04

Hamilton House 02/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Hamilton House 10 Crescent Road Bromley Kent BR1 3PN Lead Inspector Ann Wiseman Unannounced Inspection 17th May 2006 08:30 Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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 Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hamilton House Address 10 Crescent Road Bromley Kent BR1 3PN 020 8460 9046 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) Bromley Autistic Trust Stephen O`Brien Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: Hamilton House is a detached residence located in Bromley North. It is close to the shopping area and is well served by public transport including main line rail services. Although Hyde Housing Association owns the building the 24-hour care and support is provided by Bromley Autistic Trust. The home provides care and support in a home-like environment for five service users. Each service user has their own bedroom and there are a number of communal areas. The service users in this home suffer from Autism. The home is staffed for 24 hours a day. Overnight there is sleeping-in staff plus on-call support. Service users are assisted to develop daily living skills within a home-like environment. Integration into the community, attending day centres and adult learning facilities are all incorporated into daily routines. Maintaining family contact and open visiting is encouraged. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection started at 8.30 am and the Inspector was on site for 5½ hours. During the visit the Inspector was able to speak with three of the service users, two staff members and the Registered Manager. Subsequent to the visit the Inspector spoke to two family members by phone and sent User Surveys to all the rest of families and some of the other professionals involved in the service. The Inspector would like to thank all those at the home who gave her a warm welcome and who were helpful and open throughout the Inspection. The family members that the Inspector spoke with were positive in their comments; saying that they were happy with the care their children received and that they felt that the staff were competent and knowledgeable of the Service Users needs and that their Sons appeared happy living at the home. One of the Service Users parents commented that the house appeared a little run down and felt it would be nice if it was decorated but believed it to be clean despite the house not having a cleaner. She felt that having a cleaner would enable the staff to spend more time with the Service Users. On arrival the Inspector found all the Service Users at home, they were either getting ready for the day centre or having breakfast. The atmosphere was congenial with Service Users chatting with staff and each other. One of the Service Users has declined to attend the day service since changes to the program has made it less desirable to him. Being Autistic he finds any change difficult and he was disappointed that they had changed the program he had been doing for many years. He has been supported by the staff to develop a program of daily activities that he was keen to explain to the Inspector. The need to support Service Users at home during the day has stretched the service and the home is seeking support via direct payments to replace the day service. The house was clean and tidy throughout and despite some areas being in need of redecoration it is homely and comfortable. All the bedrooms reflect the Service Users interests and hobbies and are furnished to appropriately. What the service does well: The home is to be commended on the quality of care plans it has produced, they are detailed and comprehensive and the Inspector believes that anyone reading one of the care plans would have a good knowledge of that Service User, his preferences and his needs. Also the newly completed Person Centred Plans (PCP) are of a high standard and have obviously been produced with the Service User involvement and have been produced in a format that is easier for the Service Users to understand. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 6 The home had put it’s Statement of Purpose and the Service Users guide on audio tape to make it accessible to the those that are unable to read. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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 Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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): All standards were assessed on this occasion Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. All required information was available in a format accessible to those that are unable to read and although there have been no changes in occupation for over four years the policy for assessing and receiving new Service Users is to requirement. EVIDENCE: The home has put it’s Statement of Purpose and the Service Users Guide on audio tape to make it accessible to the those that are unable to read. Service Users folders that were inspected contained assessments made prior to their move that examined their aspirations and needs. The group of Service Users that live at the house now have all been together for many years, the last new person moved in over four years ago. The Manager has assured the Inspector that he would follow the homes procedure in the event of a vacancy arising. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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): All standards were covered on this Inspection Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. This home has enabled the Service Users to live active lives while supported to make decisions for themselves and to take risks as part of an independent lifestyle. EVIDENCE: The home has completed it’s transition from formal annual review meetings to Person Centred Plans (PCP) and the finished folder is of a high standard, it is obviously compiled with the Service User’s participation and sets out their history, likes, dislikes, fears, hopes and aspirations. It is laid out in an attractive way with illustrations and photographs personal to the Service User. It is planned that the PCP will be reviewed at regular intervals. One of the Service User’s has chosen not to take part in the PCP process immediately and has preferred to have his review as before, the home has facilitated this and the Service User has now agreed that next year he will have Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 10 a go at the PCP meeting. It is good that the home has been able to be flexible in it’s approach to the Service User’s wishes. The same Service User has chosen to stop going to his day centre after many years attendance as the recent changes to the service had not suited him. Despite the difficulties caused by the need to supply staff support while he is away from the centre, the home has excepted his decision and have helped him plan activities and support him to participate in them. User Meetings are held when everyone is encouraged to have their say, records are taken and issues raised are discussed at staff meetings. The Inspector examined the notes and they show that the meetings are regularly. Initially the expectation was that the meeting would be held weekly, but the Service Users decided that it was too often and it was agreed that the meetings would be held fortnightly. Service Users are also consulted on the menu and can have a different meal if on the day someone has changed their mind. Service Users prepare their own breakfast and simple meals such as sandwiches, and are encouraged to help prepare the main meal. They are responsible for keeping their own rooms tidy with support and will help to do their own laundry. Service Users will travel independently both locally and to and from their parents house using public transport. Extensive and detailed risk assessments have been drawn up to support people to take risks as part of an independent lifestyle. Personal information is stored in the office in a locked cupboard. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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): All standards in this section have been examined. Quality in this outcome areas is good. This judgment had been made using available evidence including a visit to this service. The Service Users benefit from being offered opportunities for personal development, to take part in appropriate leisure activities, to be part of the local community and to keep in close contact with their families. EVIDENCE: Service Users in Hamilton House have opportunities to develop personally by attending various adult education classes included swimming, pottery, computer skills and English grammar and writing. Of the five Service Users two have opted out of attending the day centre; a full itinerary has been developed in lieu of it for one and the other Service User works at the Community Café run through the day service. Some of the Service Users attend clubs and Church and present a strong community presence by using the local amenities such as the library, cinema, pub’s and local fitness centre. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 12 Service Users families play a large part in their lives and visits to parents home are normal and friends and relatives are invited to BBQ’s and parties at the home. It has been confirmed by family members who spoke with the Inspector that they are included in the Service Users life and are invited to review meetings etc. and are kept informed. Interaction observed between staff and Service User was friendly, open and respectful. People are given choices in their day to day lives and share reasonability’s within the house such as cleaning their rooms, shopping and helping with the laundry. Care plans developed from the PCP set out responsibilities along with hopes and aspirations. A Service User who spoke with the Inspector spoke of the tasks he carried out in the house and of how he was able to make his own mind up when it came to what he wanted to eat and of being able to have a different meal to the one prepared if he chose to. The menus, that are drawn up in consultation with the Service Users, offer a varied choice of meals with alternative suggestions were it is known that a particular Service User did not like what was on offer that day. The fridge and freezer were well stocked with a good variety of food. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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): All standards in this area were judged on this occasion. Quality in this outcome areas is good. This judgment had been made using available evidence including a visit to this service. Care plans set out how a Service User prefers to receive attention from staff. Everyone is registered with their local GP and medication is administered and stored appropriately. EVIDENCE: Care plans are written in consultation and set out how a Service User prefers to receive attention from staff members and staff indicated that they were aware of the care plans and demonstrated that they knew each Service User and their needs well. All the Service Users are registered with the local GP and are offered other mental and physical support as the need arises including specialist support from Occupational Therapy, Chiropody, Dental and Ophthalmic. The home in conjunction with the GP carry out an OK Health Check annually when weight is checked, eye tests and dental treatment is updated and they have a doctors review when medication, blood pressure and general health is checked. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 14 The medication is blistered and is stored in a locked cupboard and on examination it was found to be order with medication recorded and signed for on the MAR sheet without any omissions. The medication file contains photos of the Service Users and also a letter from the GP authorizing the crushing of tablets for one of them. There is also a copy of the homes medication policy and a list of staff signatures to allow easy identification of who has dispensed the medication. One of the Service Users self medicates and another sees to his own creams and lotions. Risk assessments have been carried out to test their ability to do this. This group of people have been together a long time and are mainly in their late middle age. It is hoped that the home will be able to cater for their needs for many years to come and to be able to support them though any illness they develop within the capabilities of the staff group. However the house would not easily be adapted for someone with mobility difficulties and preliminary discussions are in progress to cover such eventualities. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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): Both standards have been examined during this visit. Quality in this outcome areas is good. This judgment had been made using available evidence including a visit to this service. EVIDENCE: The home has had no recorded complaints since the last Inspection and nor has the Commission received any. The home has it’s complaints policy displayed for all to see and the policy contains contact details of the Commission. No staff member is employed without first undertaking an enhanced CRB check and are given Protection of Vulnerable Adult training. One of the Service Users who spoke with the Inspector felt that he would be able to make a complaint if he wanted to and said that he believed that the staff would take it seriously. Family members also confirmed that they have been given a copy of the complaints procedure. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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): Standards 24, 25 and 30 were assessed on this occasion. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. This house is homely and comfortable throughout but is let down by some of the carpets being dirty and the house is in need of a fresh coat of paint in some areas. The bedrooms suit Service Users needs and reflect their lifestyle. EVIDENCE: Hamilton House was found to be clean and hygienic on the day of the inspection, the staff support Service Users to do domestic chores and to keep their bedrooms clean and tidy. Some areas of the home have been decorated and some are still waiting to be decorated and so the paintwork looks scuffed and marked and the carpet in the lounge and some of the communal areas needs cleaning or replacing. This distracts from a home that is otherwise well decorated, comfortable, homely and suitably furnished. Please see Requirement 1 Overall the bedrooms were clean but not so tidy that the Service User was erased from the picture. Each room reflected their individuality and their hobbies and interests. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 17 One Service User buys every daily newspaper then searches for articles of interest that he will cut out and sort according to subject. This can take some time and he dislikes throwing the paper away until it has been read, consequently the build up of newspapers can be considerable and in the past this has been highlighted in previous inspections as being hazardous. However a program has been developed that encourages the Service User to recycle a few of the news papers weekly and to completely clear out the papers that have been read once a month. The Inspection took place in the week that the main clear out is due so the Inspector was able to get an impression of how many papers would accumulate each month. They were well ordered and stored out of the main pathway in the Service Users bedroom and do not form a trip hazard, the fire officer when asked his opinion by the Manager raised no objections. The Service User has a small lounge adjoining his bedroom, that is tidy and so he has plenty of room and his movements are not restricted by the accumulation of papers. As long as the program of keeping the number of papers stored is kept up the Inspector she does not believe them to be an area of concern. The kitchen floor has been replaced, a previous requirement. There are good realistic risk assessments in place that cover many aspects of the Service Users lives and underpin safe practice within the home. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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): Key standards 32, 34 and 35 were examined during this visit. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Staff on duty were aware of their roles and responsibilities, appeared competent, have access to a comprehensive training program and receive regular supervision. EVIDENCE: Two staff members were available to talk with the Inspector and both were able to speak clearly of their roles and reasonability’s, and displayed a good knowledge of the Service Users and the homes practice and procedures. Only some of the required information regarding staff records are kept on site, arrangements can be made to see them at the personnel department, this will be done for the next Inspection. However, with what was seen and with assurances from the two staff members and Manager the Inspector is content that the Service Users are protected by the homes recruitment policies and procedures. Training records were inspected and show that the staff is offered a full and comprehensive training program. Supervision notes were also seen and confirm staff members reporting that they benefit from regular supervision. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 19 Staffing levels in this home are suitable to the needs of the Service User and at night time two people do a sleep in duty to be available to respond to the Service Users needs at during the night. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Areas 37, 38, 39 and 42 were assessed on this occasion. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Service Users benefit from a home that is well run and that has their best interests at heart. There is a good quality assurance system in place the manager appears to be both competent and accountable. EVIDENCE: Discussions with the Manager indicated that his ethos for running the home was focused on achieving the best possible outcomes for the Service Users. He appeared committed and supportive and showed a good understanding of the needs of people with Learning Disabilities and Autism. He appeared organized and was able to supply information requested by the Inspector. There is a Service Review Committee that meets monthly and a representative will visit the house regularly and issues a report and makes recommendations. Two of this committee are family members of Service Users.. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 21 Service Users have regular house meetings that are normally carried out at meal times when everyone is around and records are kept. Questionnaires have been sent out to Service Users, their families and other professional bodies involved with the house and those returned were positive. A Service User who spoke with the Inspector felt that his views were listened to and were taken into account in the running of the home. A sample of health and safety areas were examined; policies and procedures were found to be in place and checks were up to date. Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 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 4 2 3 3 3 4 3 5 3 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 3 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 3 3 4 X X 3 x Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 23 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 YA30 Regulation 23(2)(d) Requirement The carpets in the lounge and some of the other communal areas are to be cleaned or replace. Areas in the home that are still in need of painting and decorating must be addressed. Timescale for action 01/08/06 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 Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup 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 Hamilton House DS0000006944.V289604.R01.S.doc Version 5.1 Page 25 - 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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