Inspection on 08/02/06 for Hamilton House

This inspection was carried out on 8th February 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 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 17/05/06

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 Monica Hanscomb Unannounced Inspection 8th February 2006 10:00 Hamilton House DS0000006944.V282033.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.V282033.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.V282033.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.V282033.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04/10/05 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.V282033.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A former registered manager carried out the inspection as the manager of the home was on annual leave. During most of the inspection service users were out attending their various tasks and activities, although the inspector did speak with two of them. The inspector briefly spoke to two members of staff who were going to accompany some of the service users; they stated they liked working in the home and especially the service users. The inspector examined records and care plans and had a tour of the building. Service users’ bedrooms are all single and are located over three floors. The whole home was found to be in need of thorough cleaning and tidying. This could be due to the home’s cleaner becoming a full-time carer. There is a service user who collects newspapers to such an extent the bedroom is now a fire hazard and the home must work with the service user to clear the bedroom of the papers however distressing. What the service does well: 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.V282033.R01.S.doc Version 5.1 Page 6 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.V282033.R01.S.doc Version 5.1 Page 7 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): 1,2,3,4,5. Service users and their families have all the information they need to make an informed choice about where to live. EVIDENCE: Service users and their families are given a copy of the Statement of Purpose and the Service Users Guide, which has recently been reviewed. Before service users make the decision to live in the home there is a programme of visits so they become known to members of staff and the other service users. This usually takes a period of one to three months. The service users are assessed before they move into the home and the findings are written into their care plan. The files seen by the inspector all included an assessment and the terms and conditions of residency. Placements at Hamilton Road are stable long-term placements. Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 8 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): 6,7,8,9,10. Service users are consulted on and participate in all aspects of life in the home. Great emphasis must be given to completing the two remaining service users person-centred plans. EVIDENCE: The majority of service users now have a person-centred plan, but unfortunately the co-ordinator had to undertake other tasks and has not completed the last two person-centred plans. Bromley Autistic trust is sending five more staff to undertake person-centred planning on a training course. Service users have the opportunity to contribute to life in the home via house meetings and key work sessions. Menu planning and activities are two of the items which are discussed at the meetings. Most of the service users visit their family home for at least one day at the weekend. All the service users’ personal files are kept in a locked cabinet. Service users go to day centres during the week but due to a day centre closing down with very little notice, staff have had to work very hard to find other activities which service users can undertake. These activities include shopping, going to the cinema, visiting and using leisure facilities. However, to many service users, the loss of the day centre where they used to work and receive pay has been a devastating blow to them. Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 9 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): 11,12,13,14,15,16,17. The home provides good opportunities for the service users to develop links in the local community. EVIDENCE: Staff support service users to participate in local community events. There is normally an activity every night for all service users. One service user is very involved with the local church with the support of staff. Regular activities in the home are baking, art, card making and one service user undertakes working on his computer. The service users also undertake swimming, going to the Gateway club or visiting the local pub. Staff who are on duty each day are responsible for preparing the service users’ meals each day. The home has a rolling menu for three weeks which service users can influence. Two service users are currently seeing a dietician. Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 10 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): These standards were not inspected at this inspection but at the last inspection most were met. EVIDENCE: Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 11 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): There are systems in place for raising complaints and concerns. EVIDENCE: The home has a complaints policy, which meets the requirements of the standards. The Commission for Social Care Inspection has no complaints regarding this home and there were no recorded complaints since the last inspection. Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 12 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): 24,25,27.30. The home is suitable to meet the needs of the current service users but the whole house is in need of a thorough clean and redecoration in all areas. EVIDENCE: The inspector had a tour of the whole home and was dismayed to see all areas of the home to be in need of a thorough clean and redecoration especially the service users bedrooms. The kitchen was found to be very greasy near the cookers and should have a deep clean. Floors and carpets were stained and toilets and bathrooms were in an unhygienic condition. Only one room in the home was tidy and that was the lounge but even there the carpet was very stained. The whole home is in a poor decorative state and cracks were seen in the walls in most rooms. One bedroom had an additional oil-fired radiator to provide more heat, which was not protected and the service user put at risk of being burnt. The manager must make this a priority. Another service user’s bedroom was found to be a fire hazard due to the service user collecting newspapers, which are kept in piles and staff are not allowed to touch the papers. However, due to the risk the collecting of these papers poses to the whole home, urgent action must be taken. The inspector realises due to the illness of the service user the home must involve the medical services and family to resolve the fire risk. There are Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 13 some extenuating circumstances because the home has no cleaner and care staff are trying to keep the home clean as well as caring for the very dependent service users. Key workers must work with the service users to on a daily basis to keep their bedrooms clean and tidy. Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 14 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): 31,32.33,35 The inspector requires staff files are made available at the next inspection to be able to substantiate recruitment and selection. EVIDENCE: The staff are aware of their roles and responsibilities and the management structures within the home and Bromley Autistic Trust. Staff spoken with stated they enjoyed working at the home and most of the staff have been working in the home for a number of years. The inspector was unable to look at the staff files as no-one had the keys to the cabinet and the manager was on annual leave. This is the second inspection when inspectors have been unable to see the files due to the manager being away and arrangements must be made to make the staff files available during any inspection. A member of staff from head office conducted the inspection but did not have access to the keys and did not know the service users all that well. The staff receive induction training before starting to care for service users and all the necessary checks are carried out before staff can commence work but the inspector was unable to substantiate any of the above standards due to the staff files being unavailable. Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 15 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): These standards were not assessed at this inspection but at the last inspection most of the standards were met. EVIDENCE: Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 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 1 25 3 26 x 27 3 28 x 29 x 30 1 STAFFING Standard No Score 31 2 32 2 33 3 34 x 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 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 x x x x x x x x x x x Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 17 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 YA24 Regulation 23.2b 23.4 Requirement Timescale for action 01/09/06 2 YA30 23(2)(d) The registered person must ensure the premises are of sound construction and kept in a good state of repair externally and internally. The registered person shall 01/06/06 having regard to the number and needs of the service ensure all parts of the care home are kept clean and reasonably decorated. 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 3 Refer to Standard YA35 YA32 YA31 Good Practice Recommendations The inspector was unable to assess this standard because the staff were unavailable for the second time The inspector was unable to assess this standard because the staff files were unavailable for the second time. The inspector was unable to assess this standard because the staff files were unavailable for the second time. Hamilton House DS0000006944.V282033.R01.S.doc Version 5.1 Page 18 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.V282033.R01.S.doc Version 5.1 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!