Inspection on 28/07/05 for Harding House

This inspection was carried out on 28th July 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harding House 26/01/09

Harding House 12/09/06

Harding House 20/12/05

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 Announced 28 July 2005 9:45am th 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. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Harding House Address 70 Wandsworth Common Northside Lonson SW18 2QX 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 8870 3653 020 8874 6716 Riverhaven Mrs Maria JW Saward Care home only (PC) 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (MD) of places Sensory impairement (SI) Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17th February 2005 Brief Description of the Service: Harding House is a care home registered to provide care and support to ten residents with mental health needs and who also have a hearing impairment. There are currently three females and seven males accommodated at the home. 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 areas. Harding House is a large Victorian house with accommodation provided over three floors with a good size garden to the rear of the home. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day for approximately 6.5 hours. An interpreter was present for 2 hours to assist the inspector, where appropriate, when communicating with residents and staff. A tour of the premises took place and staff and care records were inspected. Two of the staff on duty and five of the service users were spoken to during the inspection. Twenty comment cards were received in respect of the service. Seven of these were from relatives/ visitors, three from social care professionals and ten from residents at the service. These are referred to throughout the report. What the service does well: What has improved since the last inspection? Since the last inspection the home has developed the Statement of Purpose to include relevant information about the service to existing and potential residents. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 6 The home has made developments to medication record-keeping, including the introduction of a new medication administration system. The previous inspection identified a number of environmental issues that have been addressed, including the installation of a new dishwasher and other repairs to the kitchen area. The home is currently in the process of refurbishing all the bathrooms and toilets throughout the house, and these are being carried out to a good standard, with close attention paid to the individual décor of these. Positive steps have also been made to ensure that designated smoking areas are away from the dining and kitchen areas. Further steps have also been made to the management of staff, with the staff team receiving appropriate supervision and training to meet the needs of the residents. 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 G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 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 Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 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 The Statement of Purpose contains adequate information about the service aims and facilities. The Service Users Guide needs to be developed to ensure it provides all relevant information about the home. EVIDENCE: There is a well-presented Statement of Purpose that provides detailed information about the services offered by Harding House, the staff team and details of the accommodation at the home. Since the last inspection the Service Users Guide has been updated to include details of where the inspection report can be accessed and the contact details for the CSCI. Further work is needed to ensure that the guide contains a copy of the terms and conditions and contract in respect of the accommodation provided. The complaints procedure must also be included in this document along with the contact details of the CSCI. The guide should also include the qualifications and experience of the provider, manager and staff team. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 There is a user-friendly care planning system at the home that provides adequate information on the needs and interests of the residents. Areas of risk are minimised through appropriate risk management plans. EVIDENCE: Three residents care files were examined and found to be well-formatted throughout. The structure of each file leads the reader through an initial summary of the needs of the resident and contact information of professionals involved in their care. Following this there is a summary sheet that gives a brief outline of the care required for each resident in relation to areas such as their mental health needs, daily living skills and financial needs. The design of the care planning system is of a high standard as it embraces the principles of good care planning; where they are of simple design, easy to understand and individualised to each residents current needs. Furthermore, the design enables the care plans to be easily understood and accessible to the staff and individual. There was also observed to be a WIDGET care plan in each persons’ file which provides a symbolic interpretation for the use of the resident. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 10 The risk assessment format in use at the home uses a scoring system for assessing the severity of the identified risk along with the likeliness that it will occur. The three residents files were observed to contain a number of risk assessments that are individualised to needs eg. aggression/ behaviour/ safety around hot temperatures/ etc. Recent notifications received by the CSCI from the home about incidents concerning residents were followed up and found to be adequately incorporated into risk management plans. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 The home benefits from an activities co-ordinator who supports the general interests of the residents to develop themselves personally and socially. Residents are supported to maintain links with family and friends. EVIDENCE: The home has an activities co-ordinator who works with residents across three homes run by the organisation. The home has a good record of all activities carried out by the residents that is presented in a written format along with photographs of each event/ trip. The activities range from in-house to community-based outings, eg. cooking groups, trips to the seaside and visits to local places of interest. The care records for each resident contain a timetable of structured activities that they are involved in. These were seen to be related to the needs and preferences of the residents, with one timetable including activities such as going to the gym, working at the local supermarket and visiting friends; whereas another timetable was seen to have activities structured around inhouse domestic chores. This resident was spoken to during the inspection, where they stated that they prefer not to be involved in planned activities. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 12 When discussing activities with other residents during the inspection, one stated that they: “…like swimming…”, whereas another resident said that they would like “…more coach trips…”. Ten comment cards were received from residents at the home. In response to the question “…Do you feel the home provides suitable activities…”, a majority responded by saying “…yes…”, with some stating “…no…”. Two staff who work at the home stated that it would be good to have more staff for one-to-one activities with the residents. The inspector recently met with the activities co-ordinator at another Riverhaven home and acknowledges that his commitment and enthusiasm to working with residents is sound and that he is an invaluable resource. However he is providing activities across three homes in the organisation and, whilst doing a very good job, the feedback from residents and staff indicate he should receive more support in his work to enable more one-to-one work with individual residents at Harding House. It is therefore recommended an additional activities worker is employed to support the activities co-ordinator in their work. The manager stated that residents have varying levels of contact with their friends/ relatives and that they are supported to maintain contact when they wish, either via telephone/ visits. Most comment cards received from the relative/ visitor stated that they feel welcome in home and are satisfied with overall care provided to their friend/ relative. One commented that they are not satisfied with the care and are not consulted about important matters about the care provided to their relative/ friend, although this was not elaborated on. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 The health needs of residents are well met with evidence of good links with multi-disciplinary team members. Good record-keeping practices for the administration of medication are in place at the home. EVIDENCE: Comment cards received from social care professionals indicate that they are happy with the overall care provided at the home. In addition, the responses indicate that there is good communication by the home and that they are notified of significant events affecting the residents. The social care professionals also identify that the staff generally have a good understanding of residents’ needs and that they are able to see each resident in private when they visit. Good record-keeping was observed in the medicine administration charts, with this corresponding with the prescribed doses. Since the last inspection the home has a record of sample signatures and initials of all the staff who give out medication. The home has also recently introduced the NOMAD system of administering medication which includes a clear description of each medication prescribed for each resident. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 14 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 and 23 The complaints procedure is appropriate and accessible to residents and relatives/ visitors involved with the service. The home does not ensure that the residents safety needs are adequately met. EVIDENCE: Comment cards received from relatives/ visitors indicate that they are not aware of the home’s complaints procedure, however, they also state that they have never felt the need to make a complaint. There is a satisfactory complaints procedure in place at the home, which was seen displayed in the lounge area. The procedure was also on display in a WIDGET format for the use of residents at the home. The previous inspection required that guidelines are put in place for dealing with challenging behaviour of individual residents. These guidelines are incorporated into the risk assessments for each individual resident where necessary. The CSCI received comment cards from all the residents at the home. In response to the question “…Do you feel safe here?…” seven replied “…yes…”, one replied “…sometimes…” and two residents responded by saying “…no…” . These responses are of concern and highlight the need for the home to review the service provision with regard to safety to ensure that each resident feels safe at all times. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 15 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, 25, 26, 27, 28, 29 and 30 The communal areas throughout the home are comfortable and modern, creating a homely and modern environment for residents. The resident’s bedrooms are in a poor state of décor, requiring complete redecoration. The standard of cleaning in the home needs to be increased to ensure that residents bedrooms do not pose a health and safety risk. EVIDENCE: The previous inspection identified a number of environmental issues that needed to be addressed. It was observed that these had all been carried out in the kitchen on the ground floor, with a new dishwasher having been installed, the ceiling fan being kept clean and a gap under the oven having been repaired. The home is in the process of refurbishing all the bathrooms and toilets throughout the house. Those completed were seen to have been decorated to a good standard, with attention paid to the individualising of each bathroom, so creating a modern and comfortable environment for the residents. Since the last inspection the home has also taken positive steps in reviewing the smoking arrangements, where residents are able to smoke in designated Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 16 areas around the house, as opposed to the kitchen/ lounge area where food is prepared. A tour of the building was carried out and the home was found to be light, airy and spacious throughout with good lighting in all areas. The communal areas were tastefully decorated and homely in nature. Three resident’s bedrooms were inspected and observed to be in need of redecoration. In two of the bedrooms it was observed that the walls were badly marked and stained, with chipped paint coming away in areas around the windows. Both bedrooms were also observed to be in need of cleaning, with areas of thick dust observed on the surfaces, windowsills and lightshades, so presenting as a health and safety risk for all residents at the home. The third bedroom was clean and well-presented though in need of redecoration, as the décor looked ‘tired’ and worn in areas. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 17 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, 35 and 36 The staff team are appropriately supervised in their work and display a good attitude towards the residents. The staff team receive appropriate training to meet the needs of the residents. EVIDENCE: The previous inspection recommended that an additional member of staff work the middle day shift consistently at weekends. The staff duty rosters supplied to the CSCI demonstrate that this occurs most weekends, and the manager discussed that once the two support worker vacancies at the home are filled the weekend shifts will be adequately covered at all times. There are presently four staff and the manager permanently employed at the home. Two of these staff were spoken to during the inspection and one stated that they are looking forward to new staff being recruited to enable more individual work with residents. One member of staff discussed their work with pride, displaying a genuine caring attitude towards the residents and areas of development for the home. The training records for staff are well maintained with an individual record of courses undertaken and copies of the certificates to evidence these. The records indicate that staff have received recent training in medication awareness and fire safety. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 18 The manager showed the timetable of staff supervisions that demonstrate these sessions occur regularly, the frequency of these was confirmed by a member of staff, who stated that this occurs every month. The inspector observed that all interactions between residents and staff were respectful and positive, with a good friendly rapport between all parties. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 19 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) 38 and 42 The management of the home is generally positive and works towards promoting the interests of the residents. The health and safety of the residents is maintained through appropriate checks of equipment in the home. EVIDENCE: A comment card received from one relative/ visitor states that: “…I think (the manager) is a person who is excellent in her job…”, A further relative/ visitor commented that “…the manager is always very helpful…”. Of those relatives and visitors to the home, most commented that they are made to feel welcome and are kept informed of important matters regarding their relative/ friend. One relative/ visitor stated that the manager is “…unhelpful…” , though did not specify in what way. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 20 Two residents at the home further commented that the manager is “…nice and friendly…”, “…approachable…”. This feedback shows that the manager generally conveys a professional and caring approach not only to the residents, but also their relatives and friends. Throughout the inspection the manager demonstrated a positive and genuine caring attitude when discussing the care and service provided to the residents. Following Requirements of the last inspection the home has implemented a number of health and safety checks. These include regular maintenance of fire equipment and daily checking of fridge and freezer temperatures. Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 2 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harding House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 22 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 YA1 Regulation 5(1) Requirement The Registered Persons must ensure that the Service Users Guide provides all the required information. A copy of this must be supplied to the Commission within the timescale. The Registered Persons must ensure that the home ensures a safe and secure environment for the residents accommodated The Registered Persons must ensure that all residents bedrooms are redecorated. The Registered Persons must ensure that all areas of the home, with particular reference to the bedrooms, are kept clean Timescale for action 30/09/05 2. YA23 12(1) & 13(6) 23(2)(d) 30/09/05 3. YA24 31/12/05 13(3) & (4) 31/08/05 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 YA14 Good Practice Recommendations It is recommended an additional activities worker is employed to support the activities co-ordinator in their work. G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 23 Harding House Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Harding House G54-G04 S10193 Harding House V228910 280705 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!