Inspection on 12/09/06 for Harding House

This inspection was carried out on 12th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Harding House 26/01/09

Harding House 20/12/05

Harding House 28/07/05

Harding House 17/02/05

Harding House 15/07/04

Similar services:

Foxley Lane (121a)

Avenues (The) (Neave Crescent)

Banstead Road South (21)

Rela Goldhill Lodge

RNID

Therapia Road, 26

Annaly House

Wick Road ( 302, Flat 1 & 2)

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

CARE HOME ADULTS 18-65 Harding House 70 Wandsworth Common Northside London SW18 2QX Lead Inspector Louise Phillips Unannounced Inspection 12th September 2006 09:45a Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harding House Address 70 Wandsworth Common Northside London SW18 2QX 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) 020-8870-3653 020 8874 6716 Riverhaven Sharon Angela Smith Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Sensory impairment (10) of places Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Harding House is a care home registered to provide support to ten residents with mental health needs and who also have a hearing impairment. There are currently three females and seven males living at the service. The home is situated on a main road within walking distance of the shopping centres of Wandsworth and Clapham Junction and the transport links served by the area. Harding House is a large Victorian house with accommodation provided over three floors with a good size garden to the rear of the home. On the 12th September 2006 the manager confirmed that the fees charged by the home range from £950 to £1100 per week. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a site visit of one day and a period of time for receiving feedback from professionals associated with the service. A tour of the premises was carried out and care records were inspected along with other relevant paperwork. Time was spent talking to two staff and four residents. Information has also been gained from the inspection record for the home. Questionnaires were sent to 7 health and social care professionals and 2 of these were received back. 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. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 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 Harding House DS0000010193.V311687.R01.S.doc Version 5.2 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 and 2 Quality in this outcome area is good. This judgement has been made as there is up-to-date information about the service and the residents are well assessed prior to moving to the home. EVIDENCE: Since the last inspection one resident has moved to alternative accommodation, though no new residents have yet moved to the service. The assessment information for residents living at the home demonstrates that admissions to the service are well planned, taking place through day visits and overnight stays. A care plan is developed for this process and is reviewed after each visit. Good records are kept of each visit to the home, including how the resident spent their time, meals eaten, etc. A new Statement of Purpose and Service Users Guide has been developed for the service that provides up-to-date information about the service provided, new manager and staff team. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 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 and 9 Quality in this outcome area is excellent. This judgement has been made as resident’s needs are met by the service through appropriate risk management and care planning that involves the resident. EVIDENCE: The care files for two residents were looked at. Since the last inspection these had improved significantly to include all areas of need, with these being reviewed monthly with the input of the resident. Two residents discussed how they discuss any issues or changing needs in weekly sessions with their keyworker. The care files contain a lot of information about the individual needs, likes and dislikes of each resident. These include particular preferences in relation to such things as what they like to do throughout the day, use of alcohol, college courses, communication needs and wishes regarding taking medication. Both care plans were also in a symbol format to enable easier use for the resident. This was confirmed by a staff member who said that the format of the care plans helps the residents understand them better. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 9 Each resident has a risk assessment for any areas of their life where there could be a potential risk. These are individualised to include such areas as going out alone or where there is a history of violence, with a severity score given along with control measures and the actions to be taken by staff and the resident to minimise any risks. The CSCI had recently received two notifications about incidents involving two residents at the service, one regarding aggression and the other where a resident had sustained an injury. These were followed up during the inspection and risk assessments were seen to have been developed to manage the potential of these happening again in the future. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 10 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): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made as the residents have are involved in activities that are planned around their needs, interests and community living. Resident’s rights are respected in their daily lives, where the routines of the home are flexible and they can participate in activities if they wish. EVIDENCE: Each resident has weekly plan based on their individual preferences, such as spending time with the activities co-ordinator, going to work, going to a college course or spending time at home, where they are supported with doing their laundry and cleaning their room, etc. One resident spoke at length at how they enjoy playing golf a number of times a month, and another resident about how they are supported to go swimming regularly. Residents spoke about trips that had been arranged by the activities coordinator, with them recently having been to Hever Castle and a holiday earlier in the year. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 11 The activities co-ordinator produces a bi-monthly newsletter that informs residents of any recent events and forthcoming activities, along with suggestions from residents for trip/ activity ideas. All the residents stated that they are happy with the variety of activities that are provided and that they are regularly asked about what they would like to do, both in and outside the home. The service promotes residents to maintain personal relationships with family, friends and partners. This was confirmed by a resident saying their relative is able to visit them at the home, and another resident stating that they feel appropriately supported by staff to maintained intimate relationships. The kitchen area at Harding House has recently been refurbished to create a much more pleasant and modern area for preparing and cooking food. Residents were positive about this, saying that they enjoy spending time in the area, also that there is always enough food available when they are hungry, this also confirmed by a resident who is vegetarian. Staff support some residents with cooking meals, where others are independent in this activity. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 12 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 and 20 Quality in this outcome area is good. This judgement has been made as residents personal and healthcare needs are monitored well and supported by the home. EVIDENCE: Where residents need support with personal care, they are able to choose which staff member they would like to assist them. Any support with personal care is detailed in the individuals care plan, however most residents are independent in this and support is by way of prompting only. Throughout the inspection all residents were well presented and appropriately dressed. The care records demonstrate that the mental health needs of the residents are well monitored and appropriate action taken where a resident becomes unwell. The service has good links with the community mental health team and multi-disciplinary reviews of each resident’s care and support take place annually. The home operates the NOMAD system of medication administration. The medication for three residents was checked and the information on the labels were found to correspond correctly with the medication chart. The charts were all signed and up-to-date. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 13 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 and 23 Quality in this outcome area is good. This judgement has been made as positive work has been carried out at the home to address concerns of residents and make them feel safer. EVIDENCE: The home has the Servite Houses complaints procedure that provides guidance on how to deal with complaints and the different stages of investigating a complaint. There have been no complaints received since the last inspection. Staff records indicate that they have received recent training in adult protection, so to minimise the risk to residents. There are also policies and procedures in place regarding abuse awareness and what to do in the event of this. The findings of the previous inspection were that some residents did not feel safe living at the service. The manager described that since that time a safety questionnaire was carried out with all the residents, where they were asked about what would help them feel safer, such as more staff on duty or increased one-to-one time with staff. The responses from this were used, along with a look at issues such as the volume of residents in the lounge at any one time. The manager stated that as a result of this changes are being made to the environment, to make the lounges on the other floors more inviting for resident to spend time in. This also includes a separate smaller lounge solely for the use of female residents. Residents spoken to said that they do feel safe, one saying that they like to be with staff when they go out of the home. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 14 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, 28 and 30 Quality in this outcome area is good. This judgement has been made as good improvements have been made to make the environment much more homely and comfortable for residents. Residents are also involved in these developments. EVIDENCE: Walking into Harding House it is immediately apparent that redecoration has been carried out. The entrance area is warm, modern and inviting and this is continued into the lounge/ kitchen area. The staff office has also been significantly improved to provide a much more practical, business-like environment that now allows space for meetings to be held in confidence. The manager stated that work is still be carried out to external areas, where the five year re-painting of the outside walls is taking place along with new trellis fencing and good developments planned for the large garden at the rear of the home. The previous inspection required that all resident’s bedrooms are redecorated and refurbished. This was seen to have occurred, with new curtains and carpets, and new furniture ordered. Residents said that they were involved in choosing the colour of their room, along with the new bedding. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 15 The cleanliness of the home is maintained to a good standard, with residents being supported to look after their own room. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 16 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): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made as staff are trained for their role and appropriate recruitment checks are carried out to minimise the risks to residents. EVIDENCE: The home holds recruitment information on each member of staff. Two staff files were examined and found to contain relevant information such as proof of identification, correspondence relating to any disciplinary issues, two references, POVA First check and a record of the interview of staff. Each staff member has a job description, person specification and statement of terms and conditions for their position. One staff member was very clear about their role, speaking in detail about the individual work they do with each resident. Records indicate that all new staff are supported through an induction and probationary period and all staff receive ongoing support through supervision. There are copies of certificates of training courses undertaken, including fire safety, medication administration, protection from abuse, British Sign Language and mental health awareness. Residents spoken to comment that they are happy with the staff and that there is always enough staff on duty. Residents stated that there are occasions Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 17 when there are no deaf staff on duty, but that this was not a problem as they were still able to communicate their needs to the hearing staff. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 18 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, 38, 39 and 42 Quality in this outcome area is excellent. This judgement has been made as there is a committed and competent manager who proactively develops the service for the benefit of the residents. The health and safety of residents is ensured through regular health and safety checks. EVIDENCE: Since the last inspection there have been some changes in the management at Harding House, where the care services manager is now the Registered Manager, whilst also being Registered Manager of another similar Servite Houses care home. The manager stated that the plan is to recruit for a manager at Harding House at the end of the financial year, next March. Comments from residents about the manager are: “…she’s a good manager…”, “…she involves us in changes at the home…”, “…there when I need to talk to her…”. Staff spoken to said that they feel well-supported despite the manager working across two services. One staff member spoke about how since she has been Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 19 managing the service there has been increased team-working and that the staff work well together. Throughout the inspection the manager was observed interacting in a friendly and professional manner with staff, and delegating tasks as necessary. This approach has been a positive influence for the service, with improved systems in place and the provision of a high standard of support for the residents. The home has a good quality assurance system where such areas as complaints, resident’s involvement and activities are all monitored. In addition, there is monthly and quarterly monitoring to ensure that care plans are up-to-date, one-to-one support time with residents has been provided, that there is an adequate level of hearing and deaf staff in post at each home, etc. In addition there are meetings with residents every two months, where issues such as accommodation and decoration, trips and food preferences are discussed. Staff meetings are also held every two months. The home maintains records to demonstrate that appropriate health and safety checks are carried out on the fire system and equipment, fridge and freezer temperatures and water temperatures, gas safety, electrical testing and legionella testing, etc. Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 20 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 X 4 X 5 X 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 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 3 X X 3 X Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Harding House DS0000010193.V311687.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. 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