Inspection on 26/01/09 for Harding House

This inspection was carried out on 26th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harding House 12/09/06

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 19/06/2009.

CARE HOME ADULTS 18-65 Harding House 70 Wandsworth Common Northside London SW18 2QX Lead Inspector Louise Phillips Key Unannounced Inspection 26th January 2009 09:30a Harding House DS0000010193.V374686.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.V374686.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.V374686.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 Kpoller@servitehouses.org.uk Servite Houses 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.V374686.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2006 Brief Description of the Service: Harding House is a care home registered to provide support to ten people with mental health needs and who also have a hearing impairment. 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. The fees charged by the home range from £950 to £1100 per week. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection took place over one day and included a visit to the service by a Regulation Inspector, who was accompanied for part of the inspection by a British Sign Language BSL interpreter to aid communication with people who live at the home. When we visited we spoke to people who live and work at the home and the manager. We also looked at records, observed what was going on and looked at the environment. Surveys were received back from two people who live at the service. Sine the last inspection the Registered Manager has been on long term leave and different managers have managed the service. At the time of inspection an agency manager was overseeing the management of the home, and had been in post for approximately six weeks. This person is referred to as the manager in this report. What the service does well: What has improved since the last inspection? What they could do better: Following the findings of this inspection the home has received the rating of one star, adequate, where it had previously been rated as an ‘excellent’ service by the CSCI. This is because the findings from this inspection indicate that a number of improvements are needed to the service, and requirements have been made to address this. Areas where the home could be doing better are highlighted in the report and were discussed with the manager and deputy manager during the inspection. These include improvements to the records maintained about people who live at the service, information about staff recruitment checks, environment and health and safety checks. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 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 Harding House DS0000010193.V374686.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 People using this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Information is made available for people to help them make an informed choice about moving in, however some updating is needed to make this more comprehensive. Although an assessment is carried out on all prospective residents work is needed to improve this to ensure the home is able to meet all identified needs. EVIDENCE: The Service Users Guide at the home is available in written and pictorial format for the use of people who live at the home. Some updating is required to this document to ensure that it provides information about the current management arrangements at the service. At the time of inspection a new person was on a ‘trial visit’ to see if they wanted to move to the home. Their care file was looked at and seen to contain an ‘initial care plan’ that had been completed by the community nurse, keyworker at the home and person using the service, though had been signed by the keyworker only. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 9 The care plan is detailed and contains relevant information about communication needs, mental health needs and plans whilst on a trial visit to Harding House. There was also an Occupational Therapy assessment and information about the person’s strengths and limitations. There was no evidence of the services own assessment, or how the assessments received informs this, and the deputy manager said that they plan to work on the assessment during the trial visit period. A written assessment, using the services own format, must be in place from the initial meeting with the person. This must demonstrate the involvement of the person, or their representative, and how the service can meet their needs. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10 People using this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans are in place for people who use the service, though they are not reviewed appropriately to ensure that they are getting the right support. Improvements need to be made to the records maintained at the service. EVIDENCE: The care files for three people were looked at. The care plans focus on the individual needs of each person, where some have particular support needs around daily living skills such as personal hygiene or domestic skills, whereas the care plans for other people have been developed around their gaining more independence, safety issues and managing money. Some care files have a care plan that is in a symbol format to enable easier use for the person using the service. These were seen to refer to areas such as medication, visiting relatives, or doing domestic tasks. The person using Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 11 the service has signed these, though they are not dated, and it is unclear as to how current they are, as some differ from the care plans that are in the written format. Where necessary, any significant mental health needs of the person has been incorporated into their care plan, along with any particular areas of risk or safety needs. These include risk management plans around aggression or support when outside of the home. The incident records at the service showed that the aggression of one person was often directed at another user of the service, and whilst a risk management plan is in place for the aggressor, there is none for the receiver of the aggression, and it is required that this is put in place to minimise risks to any person who has been the focus of aggression. It is also unclear if these incidents have been reported to social services as a potential safeguarding issue. Of the three care plans and risk assessments looked at, it is unclear as to when these have actually been reviewed. An example of this is that for one person, their risk assessment has the ‘date of assessment’ as 2nd February 2009 (the inspection took place on the 26th January 2009), yet this had been signed by the keyworker to have already taken place. The care plan for one person is dated as having been reviewed on 25th January 2009, yet is dated as having been signed on the 17th January 2009. Similarly, the care plan for another person is dated 25th December 2008, yet dated has having been signed on the 22nd December 2008. In addition, it is unclear how these have been reviewed, as the care plan for one person that had been reviewed on the 25th January 2009 states that the person is ‘to continue to look for activities’ to do with the named activity officer, despite the deputy manager saying that the activity officer left this post approximately three months previously. In a similar case, the care plan for another person had not been updated to reflect significant, sensitive changes in their personal life and family relationships. Where significant events have happened for people who use the service, this must be recorded in their care file and care plans made around this, also evidence maintained of all keywork sessions and support provided. These findings do not demonstrate that proper record keeping is carried out at the service, or that the care plans are appropriately kept under review. The information in the care files are legal documents and must be accurate and upto-date. Requirements have been made to address this. The manager said that she is planning to introduce a more person-centred approach at the service and is currently arranging training for staff in this. This would be a positive progression for the service, and can be used to develop more person centred care planning and work with people who use the service. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 12 Feedback from people who use the service is that they are treated well by the staff and their privacy is respected. Staff comment that they also feel that they have built up good relationships with the people who use the service. The care files for the people who live at Harding House are stored together in large folders on a shelf in the office. It is recommended that individual files are used, that these are archived, and it is required that the files are stored in a lockable cabinet to maintain confidentiality. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 and 17 People using this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Most people who use the service are able to pursue individual activities. However, there has been a reduction in activity provision and some people are not always able to do the things they want to. EVIDENCE: On arrival at the home some of the people who use the service were already out, at work or visiting friends, whilst some were still getting ready for the day. The staff said that a majority of the people who live at Harding House are able to go out independently, whilst others need some support or supervision. During the inspection staff were observed taking different people out to the shop or post office throughout the day. People who live at the service said they are able to have friends and family visit them at the home, and one said they can go to church when they want to. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 14 Since the last inspection the activities officer has left and there is no one currently in this position. The deputy manager said that this happened approximately three months ago, and that this has affected some activity provision at the service, with less one-to-one work taking place. The ‘residents activity folder’ held in the office had records of activities up until mid-2007 only, plus some birthday invites for 2008. The deputy manager said that due to no activity worker there has also been fewer outings for people and no holiday in the past year. Some people who use the service were spoken to, and said that they miss the activity worker, and are not able to go out so much, whereas others said that they are happy with the amount of activities and things they can do each day. The two people who use the service, who responded to our survey said that they are able to do what they want during the day and at weekends. One person, who needs support to go out, spoke to us about being ‘bored’, commenting that “…everyday is the same…”. They said they get particularly bored at weekends, as there are not always staff available to take them out. It was also observed that there various age ranges of the people who use the service, and the response from one younger person who needs support to go out is that they would like to be able to do more age-appropriate activities, such as going to pubs, or out to clubs in the evening. The findings indicate that activity provision needs to be reviewed at the service, particularly where people need support to go out, or where they would like to pursue more cultural activities. The staffing levels need to be reviewed to ensure that people who need support are able to go out when they wish, with staff support being flexibly provided over evenings and weekends. Since the activity officer no longer works for the service there has been a reduction in activity provision, outings and holidays, whereas consideration should be given to this being provided by the staff that work at the service. This would also promote a more person-centred service. People who use the service are able to prepare their own breakfast and lunch from the food provided in the kitchen. The evening meal is cooked by staff with the involvement of people who use the service, in the preparation of this. There was seen to be a range of foods, fresh, frozen, tinned and dry goods to ensure that balanced meals are provided. There was also some fresh fruits available for people to help themselves to. People said that they liked the food provided by the home. It was observed that the freezer in the kitchen on the ground floor is in need of de-frosting and cleaning as the ice is stained. The opened jars of jam and marmalade in the fridge of the top floor lounge were not labelled with the date of opening and must be disposed of. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 15 The manager said that she is currently looking to change the four-weekly rolling menu in use at the service, to that of planning the menu weekly with the people who use the service. She also said that she plans to introduce pictorial menus and recipes to assist people to choose meals. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The physical and personal care needs of people who live at the service are well met and people who use the service are assured that their medication is handled correctly. EVIDENCE: Staff said that some people who use the service need support with their personal care and this was documented in the care plans. Good records are maintained of contact that people have with health and social care professionals and speech and language therapy services where necessary. The medication for three people was checked. The medication file contains a profile of each person, including information about their medication, and how these work. It is recommended that a description of each medicine be Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 17 provided in the ‘NOMAD’ medication container so that it is easily identifiable should it be dropped or refused. All medication and records relating to the administration of these were checked and no issues identified as needing to be addressed. The training records indicate that the staff have completed recent medication training, and new staff are inducted to the policies and procedures of the service when they start work at the home. The service has a written agreement with the local pharmacy, which provide advice and support, and carry out checks on the medication held at the service. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has appropriate procedures for addressing complaints, though further improvements are needs to ensure that people who use the service are protected. EVIDENCE: The service has an appropriate complaints procedure that provides timescales in which any complaint will be acknowledged and investigated. This is also available in pictorial format for people who use the service, and on display in the hallway at the home. People who responded to our survey said that they know who to talk to if they are not happy about something, and how to make a complaint. There are policies and procedures at the service regarding what to do in the event of an abuse allegation being made at the service. The service also has the most up-to-date safeguarding procedures from the local authority. The staff training records indicate that staff have received recent training in Safeguarding of Vulnerable Adults. Staff spoken to demonstrated an awareness of what to do in the event of any abuse allegation being made at the home. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 19 During the inspection the ‘accident and incident’ records were looked at. It was found that there were three incidents that had occurred at the service during the previous year that the CSCI had not been informed of. The CSCI must be informed of any event that affects the well-being or safety of people who use the service, without delay, and a requirement has been made to address this. As identified earlier in the report, it is unclear what actions were taken following a potential safeguarding issue, that, whilst recorded in the incident reports, it is unclear if these had been reported to the local authority. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment is welcoming, homely and suits the needs of the people who live there. EVIDENCE: Harding House continues to be a modern and homely environment, which is maintained to a good standard. A tour of the building took place, and two people were willing to show us their bedrooms. The environment is light and airy, with two lounges available for the use of the people who use the service. The sofas in both lounges are looking worn, and the manager said that she has ordered some new ones to replace these. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 21 People who live at the service were happy with their rooms, though one did comment that they did not like that the curtains do not match the carpet. Some areas were noted as needing to be addressed, and these are listed below: • • • • • The paintwork on the window frames and windowsills around the home are chipped, stained and in need of re-painting The holes above the radiators in the ground floor lounge need to be repaired In the staff office, the desk in front of the shelves should be re-situated so that the folders on the shelf above are more accessible The cracks around the doorframe to room 9 need to be repaired The spare television needs to be removed from the top floor lounge The policy regarding people using the top floor lounge as a smoking area needs to be reviewed in light of people who don’t smoke living on the top floor. This is because one person who uses the service said that they are unhappy that the top floor “…smells of smoke, particularly in the evenings…”. Evidence of consultation with the local fire department also needs to be maintained to support decisions made around smoking in care homes, along with ensuring this is included in the fire risk assessment for the service. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 People using this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staff receive training that is relevant to their role. People who live at the service are not sufficiently protected by the homes recruitment procedures. EVIDENCE: Two staff files were looked at and seen to contain some relevant recruitment information. This includes a Criminal Records Bureau (CRB) check, two references, copy of identification and correspondence regarding the offer of the job. In one staff members file there is a form that gives the date of the ‘current CRB (Criminal Records Bureau check)’ as 7th March 2007, with further information stating that a new CRB is due on the 7th March 2008. There is no record of a further CRB having been obtained, or information why one would be requested within a year for this particular individual. Further work is needed to ensure all required information is kept in the files, as the two looked at did not contain a photograph of the staff member, one had only one proof of identification, whilst another had identification that was a Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 23 copy of their passport, which had expired 8 months before they started work. There was no evidence of the interview with staff, or of how gaps in their employment had been followed up at interview. The deputy manager said that the shortfalls in information at the service is because this is held at the human resources department for the organisation. We asked that evidence of the missing information be provided prior to the report being written. This had not been received at the time of writing the report. The supervision records for both staff indicate that they have not had supervision since October 2008, and whilst they have had six supervision sessions over the past year, these need to be at regularly spaced intervals to ensure they are getting the right support. On arrival at the service there was only one staff member on duty. One staff member said that there is often only one member of staff on duty at weekends and throughout the week. In light of findings highlighted earlier in this report, and under ‘Lifestyle’, the staff numbers must be increased to have a minimum of two staff work at all times, to ensure the safety of staff, minimise risks to people who live at the home, and ensure that people who need support to go out are able to do so when they wish. Feedback from some people who use the service is that there are not always enough staff on duty to support them. Shortly after we visited the home an incident happened, and due to only one member of staff being on duty at the time, they were unable to seek medical assistance until another member of staff arrived at the home, where had there been more staff this delay would not have occurred. New staff receive an induction and undergo a period of probation to ensure they want to work at the home, and that they are suitable. Training records indicate that staff have undertaken recent training in mental health awareness, moving and handling, food hygiene, first aid, fire safety and risk assessment. Most staff are trained in British Sign Language, and have obtained the NVQ level 3 in Care. The manager said that she is looking at more specific training for staff to do, in areas such as the menopause, sexuality and relationships, and travel training for people who need assistance to go out Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 People using this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Changes in the management have led to inconsistencies in providing a quality service for people living in the home. Health and safety is generally of reasonable standard. EVIDENCE: Since the last inspection there have been some changes to the management at Harding House, with the Registered Manager having been being on long-term leave for approximately five months, and interim managers have managed the home during this period. The organisation should consider proposing a different person to be the Registered Manager if the current Registered Manager has not returned from leave after a period of six months absence. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 25 Currently there is an agency manager running Harding House and another similar Servite Houses care home. The manager had been in post approximately six weeks at the time of the inspection. The manager said she has previously managed a supported housing service and has a number of years experience working with people with mental health needs and challenging behaviour. She said she is applying to start BSL training in April 2009. She said she has regular contact and support from her line manager. The manager had a good understanding of areas of improvement needed for the service, and acknowledged changes that need to be made to provide a service that meets the needs of all the people who live there. However, since the last inspection the changes in the management of the service has had a negative affect on the provisions of what had previously been judged as a ‘excellent’ service by the CSCI. This is reflected in the number of requirements and recommendations given towards the end of this report, which are as a result of the findings from this inspection, and to address issues identified. The quality assurance system at the service includes a monthly monitoring of different areas, such as activities, complaints and checking care plans. Regular meetings also take place with the staff and people who use the service. The most recent report to evidence the monthly visits, in accordance with Regulation 26 of the Care Homes Regulations 2001, is dated January 2009, and the one prior to this October 2008, with no reports between this time available. A requirement has been made to address this, to ensure these visits are carried out monthly, and a record maintained at the service. As stated earlier in this report, the findings indicate that records held about people who live at the service are not being maintained and recorded properly, and a requirement has been made to address this. Appropriate health and safety checks are carried out around the home, with records to demonstrate that up-to-date checks had been done on the portable appliances, gas safety and fire system. There was no evidence available to demonstrate that a recent electrical installation check had been carried out. Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 26 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 2 2 2 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 2 LIFESTYLES Standard No Score 11 3 12 2 13 2 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X 2 2 X Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 27 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. 1. Standard YA1 Regulation 5 Requirement The Service Users Guide must be kept up-to-date and contain accurate information about the Commission contact details. This is so that people who use the service are provided with the right information. 2. YA2 14 A written assessment, using the services own format, must be in place from the initial meeting with the person. This must demonstrate the involvement of the person, or their representative, and how the service can meet their needs. This is so that the service can demonstrate that they are able to meet the needs of the person using the service. 3. YA6 15 The care plans must be kept under review and revised when necessary. This is so that the care planned and provided is relevant and what the person who uses the Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 28 Timescale for action 28/02/09 28/02/09 28/02/09 service needs and wants. 4. YA9 13(4)(c) A risk assessment and management plan must be in place for the receivers of aggression, particularly where this is often the same person. This is so that risks to people who use the service are minimised. 5. YA10 YA41 17 All records relating to people who use the service must be kept up-to-date and kept securely at the home. This is so that people who use the service are assured that information about them is kept confidential. 6. YA12 16(2)(n) People who use the service must be supported to pursue recreational activities appropriate to their age. This is so that people who use the service get the care and support they want. 7. YA13 16(2)(m) People who use the service must be supported to pursue individual interests with support as necessary. This is so that people who use the service get the care and support they want. 8. YA17 16(2)(i) Opened jars of food must labelled with the date opened and disposed of as necessary. Any unlabelled food must be disposed of immediately. This is to ensure that people using the service are provided Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 29 28/02/09 28/02/09 31/03/09 30/04/09 31/01/09 with suitable and nutritious food. 9. YA23 37 The Registered Person shall give notice to the Commission, without delay of any event in the care home that adversely affects the well-being or safety of any person who uses the service. This is to assure people who use the service that incidents are managed appropriately. 10. YA24 23 The environmental issues, as listed on page 22 of this report, must be addressed. This so that the home is safe and comfortable for the people who live there. 11. YA33 18(1)(a) The Registered Persons must 31/03/09 ensure that there are a minimum of two staff work at all times. This is to ensure the safety of staff, minimise risks to people who live at the home, and ensure that the support needs of people living at the home are fully met. 12. YA34 19, Schedule 2 The Registered Persons must ensure that all required recruitment information is held at the home. This is to assure people that use the service that suitable staff are employed at the service. 13. YA39 26 The Registered Persons must ensure that visits in accordance with this regulation are carried out, and a report maintained of this at the service. So that people who use the Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 30 31/01/09 30/04/09 31/03/09 28/02/09 service are assured that the quality of the service is monitored and actions taken where necessary. 14. YA42 23(1)(a) An up-to-date electrical installation certificate must be held at the service to demonstrate that these checks have been carried out. This is so ensure the safety of the facilities for people who use the service. 28/02/09 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 YA10 Good Practice Recommendations The service should implement individual care files to hold information about each person using the service, and these should be archived so that the most up-to-date information is held. Staff support for people who use the service should be flexibly provided, including evenings and weekends, and this should be recognised as part of staff duties. A description of each medicine should be provided in the ‘NOMAD’ medication container so that it is easily identifiable should it be dropped or refused. All staff should receive a minimum of six structured supervision sessions each year, at regularly spaced intervals. Records need to be maintained of these sessions. 2. YA13 3. YA20 4. YA36 Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Harding House DS0000010193.V374686.R01.S.doc Version 5.2 Page 32 - 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. 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