Inspection on 25/04/05 for Hampton Road East (89)

This inspection was carried out on 25th April 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hampton Road East (89) 31/08/06

Hampton Road East (89) 10/11/05

Hampton Road East (89) 27/09/04

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 89 Hampton Road East Hanworth Middlesex TW13 6JA Lead Inspector Susheila Ramcharran Unannounced 25 April 2005 at 9.40am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 89 Hampton Road East Version 1.10 Page 3 SERVICE INFORMATION Name of service 89 Hampton Road East Address Hanworth, Middlesex TW13 6JA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8941 8228 020 8941 6228 Grove Care Partnership Limited Care Home 7 Category(ies) of Learning disability (0), Physical disability (0), registration, with number Sensory impairment (0) of places 89 Hampton Road East Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 27/9/04 Brief Description of the Service: 89 Hampton Road East is a detached house, situated in Hanworth close to a supermarket and with access to the M3. It has a gate, which is locked, and is electronically controlled for security purposes. Parking is available at the front of the house. The home was registered in May 2004 and the Registered Providers are Grove Partnership Ltd. Feltham main line and Hounslow underground stations can be reached by buses, which are easily accessible. The home provides accommodation for seven service users, of both sexes, with learning disabilities and sensory impairment. There were six service users at the time of the Inspection. There are seven single bedrooms, four on the first floor and three on the second floor. Each bedroom has en-suite facilities, comprising a bath, shower attachment, toilet and basin. A separate bathroom with a walk in shower and a toilet is available. There is no lift and all areas of the home have to be accessed by stairs. There is a spacious lounge on the ground floor and a nicely furnished conservatory, which overlooks a large, wellmaintained attractive garden with a summerhouse at the end. There is a kitchen, separate dining area, office, quiet room and a staff sleeping room on the ground floor. A laundry room, with a washing machine and a dryer, is located on the first floor.The staff team provide personal and practical support to the service users. The home has its own transport. Leisure and social activities are arranged in accordance with the wishes of the service users and as agreed by the relatives and the Placing Authorities. 89 Hampton Road East Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on the 25th April 2005, as part of the regulatory process, commencing at 9.40am and for a total of eight hours. A tour of the building took place and discussions held with four support workers and the Manager Designate. The documentation examined included the samples of the staff files, health and safety records, maintenance records, complaints file, accident and incident records, and the medication records. The medication storage was also examined. The home had an acting manager, on a temporary basis, until an appointed permanent manager commenced. All of the service users were seen during the course of the inspection. Service users were engaged in activities in the community and within the home. Public transport is used for some of the trips but the home’s transport is used to take service users to attend their community activities. What the service does well: What has improved since the last inspection? What they could do better: Additional permanent staff team are required to provide continuity of care for the service users. 89 Hampton Road East Version 1.10 Page 6 The staff recruitment records need to be updated retrospectively. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 89 Hampton Road East Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 89 Hampton Road East Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 The home has the information needed to inform service users and their representatives about the services provided. The assessment procedures are in need of improvement to be able to demonstrate that service users’ needs could be met, prior to admission to the home. EVIDENCE: The Statement of Purpose and the Service Users’ Guide have been updated since the previous inspection and again to reflect changes in the staff team. Regulation 6 (b) of the Care Homes Regulations 2001 requires that the Commission for Social Care Inspection, and the service users, be informed of any revision of these documents within 28 days. In addition, the room sizes, and the home’s inability to have service users with mobility difficulties, were included. These documents have been produced in large print and the “Widget” visual form, to meet the needs of the service users. The service users’ records examined did not contain the details, required at the previous inspection, in respect of confirming to service users, in writing, that the home could provide the care as assessed. A sample letter confirming that the assessed needs could be met was sent to the Commission for Social Care Inspection following the previous inspection visit. These need to be sent to service users and their representatives to verify that the placement is satisfactory. 89 Hampton Road East Version 1.10 Page 9 A previous requirement was for the home to have systems in place to ensure that appropriate assessments are undertaken. This was to make sure that prospective service users are thoroughly assessed and it can be demonstrated that their needs can be met. The Acting Manager stated that work to improve the current needs-led assessment proforma is planned. No new service user has been admitted since the last inspection. 89 Hampton Road East Version 1.10 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9. The Acting Manager has commenced work to improve on the current service users’ plans and to complete risk assessments for all service users. This should ensure that the quality of their care and overall safety is improved. EVIDENCE: Each service user has a lifestyle plan, which was drawn up by the home following their admission. This includes healthcare needs, activities, self-image and choice. The Acting Manager has commenced work to review and improve the current care plans which would be more specific in addressing service users’ identified needs. One sample of a completed care plan, which had been revised, was seen. This was detailed and contained guidelines on how to support the service user on a twenty-four hour basis. Reviews are held routinely on a three monthly basis with all the relevant professionals involved. The home was previously required to ensure that risk assessments have taken place for activities in which individual service users participate, both indoors and outside the home. Guidelines were seen in respect of a variety of service users’ activities, including smoking, road safety, swimming and independent access to the water supply in the bedroom. 89 Hampton Road East Version 1.10 Page 11 All of the service users need support to go out in the community. The Manager Designate stated that the work on risk assessments is in progress and still to be completed. There is a fire risk assessment but a general environmental risk assessment, which needs to include the safe use of the kitchen, stairs and the garden, was not available for inspection. 89 Hampton Road East Version 1.10 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,14, 15,17 Service users participate in a variety of activities, according to their individual assessed needs, within the home and in the community. This has resulted in personal development, promoted social contact in the community, increased contact with relatives and involvement in meal preparation in the home. Improvements were noted in the service users’ behaviour, which has resulted in a calmer atmosphere in the home. EVIDENCE: Each service user has an activity programme for the week. Five of the six service users are involved in community activities. On the day of the inspection visit, service users were participating in a variety of activities. These included attendance at college, undertaking lessons in Information Technology skills, Adult Life Skills, the hydrotherapy pool and music lessons. Staff assist with transport and support service users to attend their activities. The staff stated that several service users are interested in using the computer and arrangements are being made to facilitate this activity. There was evidence to demonstrate that discussions are taking place with one service 89 Hampton Road East Version 1.10 Page 13 user, who is reluctant to participate in community activities, to attend a day centre. This service user is also being supported to write a book. All the service users have relatives and all have overnight stays with them. One service user previously spent the day with relatives but this has increased to overnight. One service user is supported to maintain a personal relationship. Service users were observed to be participating in the preparation of the evening meal. Records are kept of the meals taken by individual service users. Alterations are made on the menu to record any changes. Evidence was seen, in one service user’s records, that the dietician has advised on a providing a varied, high fibre diet, with adequate fluids, for the service user. This was actioned. 89 Hampton Road East Version 1.10 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 The health care needs of the service users have been identified and there is evidence to demonstrate that the appropriate professionals’ input is sought to meet these needs. Shortfalls in the medication administration system could have a potential to place service users at risk. EVIDENCE: The service users records examined evidenced that the General Practitioner, the language and speech therapist, the community psychiatric nurse, the psychiatrist and the community team for people with learning disabilities are involved in the service users’ care. All incidents and accidents are recorded. Those requiring notification under Regulation 37 of the Care Homes Regulations 2001 are reported to the Commission for Social Care Inspection. A sample of the medication administration charts and the medication were examined. The Acting Manager stated that concerns remain with the system used for the administration of medication to one service user. The service user’s parent currently supplies the medication, which is obtained overseas and needs to be translated into English. In addition, staff are signing a medication administration sheet and are not fully aware of the medication taken. This service user is self-medicating. No risk assessment in respect of this has been completed. The Commission for Social Care Inspection Pharmacy Inspector has 89 Hampton Road East Version 1.10 Page 15 been asked to carry out an inspection on the systems in place in the home. The Acting Manager has been asked to have a completed list of staff signatures of those responsible for medication administration. The staff also need to mark the starting date of medication not stored in the dosette, such as painkillers and laxatives. None of the service users was on controlled medication. 89 Hampton Road East Version 1.10 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23. The home has complaints, adult protection and whistle blowing policies and procedures. This would give the service users and their representatives the reassurance that their complaints and concerns would be listened to, taken seriously and investigated. EVIDENCE: The home’s complaints policy and procedure includes a response time for investigating complaints and details the complainant’s rights to contact outside agencies, including the Commission for Social Care Inspection. However, the procedure seen in the Service Users’ Guide does not clearly state that the Commission for Social Care Inspection could be contacted at any stage of a complaint nor does it give the timescales for response. These need to be included to clarify the procedures. There is a complaints book in which complaints are recorded. There were three complaints, which were investigated. Two have been satisfactorily resolved and one is in the process of being resolved. The staff team have had training in Adult Protection issues, from the Adult Protection Coordinator from the London Borough of Hounslow, as part of their induction when the home was registered. One night worker spoken to stated that she had not undertaken the training but is aware of the issues. A number of the staff have since left. The Acting Manager stated that further training is planned. She was awaiting a date from the Adult Protection Coordinator, who would be facilitating the training. The staff spoken to during the visit were aware of adult protection issues. One service user had some bruising which was thought to have occurred while a musical instrument was being played. This was referred to the Adult 89 Hampton Road East Version 1.10 Page 17 Protection team, the Commission for Social Care Inspection and the care manager for the service user. The Acting Manager was waiting for a response at the time of the inspection to progress the issue. A sample of the service users’ finances and records were checked. These appeared to be in order. Individual books are maintained and receipts kept for purchases made on behalf of the service users. All the service users were reported to have appointees and only small amounts of cash are held on their behalf. The Acting Manager stated that she plans to review the system currently in place to allow for easier monitoring and improved practice. 89 Hampton Road East Version 1.10 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 30 The furnishing, equipment and décor of the home provide a domestic setting and a homely environment for the service users. The home was clean, meets current health and safety, fire and environmental requirements, which provides security for the service users. The home is not suitable for service users with mobility difficulties. EVIDENCE: A tour of the building both internally and externally was made. Six service users were in residence at the time of the inspection visit. Each bedroom has under floor heating, with thermostats that can be individually controlled. The hot water is thermostatically controlled to allow delivery at the recommended safe level. Public transport, or the home’s car, can access the local community facilities easily. The home is located off a busy main road. The gate to the entrance to the home is electronically controlled to provide security for the service users and staff. The home was clean and there were no odours. The kitchen and laundry areas were clean and free from hazards. 89 Hampton Road East Version 1.10 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, There has been a high turnover of staff since the home’s registration and a high level of bank staff employed. This does not ensure consistent care for the service users. There was a lack of evidence to demonstrate that service users are protected by the home’s recruitment policies and practices. EVIDENCE: Four staff spoken to during the inspection visit stated that several staff had left, including the manager and deputy manager. A second deputy manager was leaving at the end of the week. The roster examined showed that a high level of bank staff are employed. The employment checks carried out for the employment of staff demonstrated that there were gaps in the procedure. Four of the staff files examined did not contain all of the records required by Regulation 17 (2) Schedule 4 and Regulation 19 (1) (b) of the Care Homes Regulations 2001. For example, not all had two references, the start date of employment or the number of contracted hours. There were incomplete application forms, no company stamp or other verification of the authenticity of references, and one file had no employment checks. The employment records must be completed for all of the staff employed in the home in line with the Care Homes Regulations 2001. 89 Hampton Road East Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 42, 43 There has been a lack of permanent management staff in the home, a period without a manager on a day-to-day basis, and a newly appointed Deputy Manager in charge. This is not conducive to providing a good quality of care and could have put service users at risk. EVIDENCE: There was at least two months when a newly appointed deputy manager was acting manager for the home. An acting manager commenced full time at the end of March 2005. A permanent manager has been appointed and is due to commence work on the 22nd May 2005. A number of other staff have left. Whist this did not have any obvious detrimental effects on the service users, staff reported that it has been a strain on the permanent team. An example given was that of working regularly with temporary staff, some of whom may only work two shifts a month. The recruitment and retention of a permanent staff team is vital to maintain a good quality of care and support to the service users. 89 Hampton Road East Version 1.10 Page 21 The records seen indicated that staff did not have the required amount of fire drills a year. This must be rectified for the safety of service users and staff. The hot water is scheduled to be tested weekly but no records were seen for the month of February 2005. Fridge and freezer temperatures were taken twice daily and were recorded as above the recommended temperatures, on several occasions, but there were no records of action taken to rectify this. This was brought to the attention of the Acting Manager who addressed it at the time of the visit. The certificate of insurance was displayed and there is adequate insurance cover as required. The Manager Designate stated that work was being done to produce a business plan for the future and she had a staffing budget. The home should an allocated budget for all the required items, such as food and training. 89 Hampton Road East Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 89 Hampton Road East 3 x x 3 3 Standard No 31 32 33 34 35 36 Score x x 2 2 x x Version 1.10 Page 23 16 17 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 2 89 Hampton Road East Version 1.10 Page 24 NO 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 2 Regulation 14 (1) (a) (b) (c) Requirement The home must demonstrate that appropriate assessments can take place and the needs of prospective service users can be met before admission is agreed. Risk assessments must be carried out for all activities undertaken by the service users and the enviroment. (Timescale of 30/10/04 not met) The medication procedures must include the dating of medication starting and signatures of the staff administering it. The complaints procedure in the Service Users Guide must be completed in accordance with Regulation 22 of the Care Home Regulations 2001. The records required by the Care Homes Regulations 2001 must be in place for all staff employed in the home. Every effort must be made to employ an experienced and permenent staff team. All staff must participate in regular fire drills. Maintenance tests must be seen Version 1.10 Timescale for action 31/07/05 2. 9 13 (4) (b) 31/5/05 3. 20 13 (6) 31/5/05 4. 22 22 30/6/05 5. 32 6. 7. 8. 33 & 37 42 42 17 (2) Schedule 4 19 (1) (b) Schedule 3. 18 (1) (a) 23 13 (4) (c) 30/6/05 31/7/05 30/6/05 31/5/05 Page 25 89 Hampton Road East to be recorded. 9. 42 13 (4) (c) Action must be seen to be taken when fridge and freezer temperatures are recorded outside of the safe levels. (Timescale of 30/10/04 not met) Information to show financial viability is required to be available for inspection. 31/5/05 10. 11. 12. 43 24 30/6/05 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 Good Practice Recommendations 89 Hampton Road East Version 1.10 Page 26 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 89 Hampton Road East Version 1.10 Page 27 - 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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