Inspection on 27/04/06 for Harrowdene Lodge

This inspection was carried out on 27th April 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harrowdene Lodge 21/08/07

Harrowdene Lodge 01/03/05

Harrowdene Lodge 02/06/04

Harrowdene Lodge 27/01/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Harrowdene Lodge 120 Harrowdene Road Wembley Middlesex HA0 2JF Lead Inspector Dia Balraj Key Unannounced Inspection 27th April 2006 Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Harrowdene Lodge Address 120 Harrowdene Road Wembley Middlesex HA0 2JF 020 8908 3504 020 8908 6078 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) Ms Kayte Regina Pinto Ms Kayte Regina Pinto Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1/3/05 Brief Description of the Service: 120 Harrowdene Road is small privately run care home providing personal care and accommodation for up to 4 service users with mental health problems and learning disabilities. At the time of the inspection there was 1 service user in the home. The fees are £1740.00 per week. The home is situated in a pleasant residential area. It is an extended semi-detached house in Harrowdene Road, which is off North Wembley High Street. It is easily accessible by British Rail and buses. It is close to shops and to local amenities. There is off-street parking for about 2 cars and there is additional parking on the road. Accommodation for service users is provided on 2 floors in single bedrooms. There are two bedrooms, a kitchen, conservatory, a communal lounge and dining areas on the ground floor. There are toilets and bathrooms on each floor. On the first floor there are 2 service users’ bedrooms, the sleep-in room for staff and a small office. There are some bushes in the front of the home and there is an extended area at the back of the home with a patio, a lawn and a few trees. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection started at 9:30 in the morning and lasted six hours.. There was only one recently admitted resident at the home. The home sustained major damage due to a fire, which occurred a year ago. Alternative accommodation for the residents was found whilst the home was being rebuilt. The residents have been accommodated in another home at Eton Avenue. Following the complete refurbishment of the building the home admitted its first resident on the 21st April 2006. The resident was present during the inspection and spoke with the inspector to discuss her life in the home. The inspector also met with the staff on duty and the manager. The inspector would like to thank the manager, the resident and staff for their help and support during the inspection. 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. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. A thorough assessment of residents’ needs is carried out to ensure that residents’ needs are met. EVIDENCE: The inspector obtained the evidence from documentation, from observation and from speaking with the resident concerned. The documentation included a Care Management assessment plan. There was also evidence of care assessments by the Manager. The manager stated that the resident had undertaken two visits to the home and had spent two days at the home prior to admission. This information was confirmed by the resident. The manager pointed out that this was the time to get to know the resident and to find out her likes and dislikes and the activities she wishes to undertake. The inspector observed that staff spent a lot of time with the resident on a one to one basis The resident stated that she wanted to familiarise herself with the area prior to joining the Day centre and staff respected her choice. The resident is currently on a trial period of three months. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. The resident’s needs are identified in her individual plan. Risk assessments were available and were being extended to cover all activities to ensure the well being of the residents. EVIDENCE: The resident had a person centred care plan. This was devised with the contributions of the Care Manager, the GP, the ward manager, the speech therapist, nurse and the Consultant. The resident stated that she wanted to get used to her surroundings prior to engaging in activities. Staff are focussing on enabling the resident to settle in her new environment. She enjoys going out for walks and shopping. The manager is looking into educational activities and community activities that meet the residents’ choices and needs. Contacts with the various agencies were documented. The resident stated that she had been involved in the planning of visits to the various agencies. The resident is gradually engaging in activities of her choice. She may be interested in, for example, helping to prepare vegetables in the kitchen. The Care Manager is required to carry out risk assessments on all activities, which the resident expresses an interest to participate in. The resident must also be given the choice to have an advocate. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 9 Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 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, 15, 16 & 17 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. The resident’s right is respected. The resident is enabled to engage in activities of her choice and is provided with a healthy diet. EVIDENCE: There was recorded evidence to suggest contacts with Barnet College and Harrow activity centre for adults with Learning disability. There was recognition from staff that this needs to be pursued with resident’s approval. There was also evidence that other activities such as swimming, library were being considered. The resident already goes with staff to the local shop and to buy the newspaper. Staff have already planned to take the resident to the local pub according to her wish. The resident was able to tell the inspector of the new friendship she had formed whilst being at the home. The resident told the inspector that staff treated her with respect and the inspector observed staff knocking on the resident’s bedroom and waiting for an answer prior to entering. The resident has a key to her bedroom. The inspector was able to observe the serving of lunch, which consisted of pizza, broccoli, cabbage and tomatoes. The resident was satisfied with the meals provided and told the inspector that she liked her lunch. It was noted Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 11 that staff had good knowledge of the resident’s likes and dislikes and were providing food according to her choice. It is required that a record is kept of the food provided to enable any person checking the records to determine whether the diet is satisfactory. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 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, 20 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. The resident receives personal support according to her choice. The administration of medication is in order ensuring the resident’s safety. EVIDENCE: The care plans for the resident showed careful and individualised planning with evidence of input from the resident. The resident choice in deciding to get used to her surroundings and meet residents from the other home was respected. There was evidence of the resident’s health care needs and assessment with recordings of health care appointments. There was evidence from records and from staff that the resident was fully involved in all matters relating to the resident’s personal wellbeing and development. The medication policy was in place. The MAR sheets were noted to be up to date and signed appropriately. The home uses a monitored dosage system of medication administration. The home has a contract with the local pharmacist, who visits twice yearly. The member of staff on duty had had medication training. There was no evidence of the resident’s consent to medication having been obtained.’ Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 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 &23 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Procedures are in place to ensure the protection of residents. EVIDENCE: The home has a complaints policy in place. The complaints procedure was displayed on the notice board and in the resident’s bedroom. The manager stated that the complaints procedure had been explained to the resident. In the discussion with the inspector the resident stated that she was happy and had no complaints and that if necessary she would make any complaints to staff or the manager. The home had an Abuse policy and the staff interviewed had knowledge of the policy including the Public Disclosure Act 1998. Staff had followed POVA training and had knowledge of the policy for dealing with Aggressive behaviour.. The home is required to obtain a copy of the London Borough of Camden POVA policy to ensure that appropriate procedures are followed if required. Records of the personal allowance of the resident were in order. The manager stated that details of the resident’s bank accounts were being forwarded. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 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 & 30 Quality in this outcome area was excellent. This judgement has been made using evidence available on the site visit. The home is comfortable and safe. The home is clean and hygienic. EVIDENCE: The home is in a quiet residential area and is within easy reach of public transport. There is off street parking for two cars and there is additional parking on the road. The home has been completely renovated since the last inspection. The rooms are well planned and some have en suite facilities. The fixtures and fittings are of a high quality, well maintained and adapted to meet the wishes of the present resident. Residents are encouraged to personalise their rooms and to bring in their own furniture. There was a homely atmosphere. The cleanliness and hygiene were of a high standard. There were no outstanding requirements from recent visits from the fire officer and environmental Health officers. The home is very well lit, clean and tidy and smells fresh. The management is proactive in ensuring a high level of maintenance. The building having recently registered had recent fire risk assessments, certificates regarding fire equipment and appliances.. . The inspector judged the water temperature to be safe for use. Window restrictors had been fitted to first floor windows Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 15 Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 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 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Residents benefit from competent and qualified staff. EVIDENCE: The home has currently one resident with 5 members of staff on its establishment. There is a member of staff on duty during the day in addition to the care manager. There is a sleeping in member of staff at night. The resident stated that staff treated her well and the inspector observed a good rapport between the manager and the resident and between the staff member and the resident. The inspector interviewed the staff member on duty in addition to checking records. The staff member on duty had followed training in the administration of medication, Manual handling, health and safety, Infection control, food handling, fire safety and POVA. She has also completed her NVQ qualification. The member of staff interviewed showed awareness of the values of privacy, dignity, independence, choice, rights and fulfilment and of translating these values in the care of the current resident. The details of the staff file examined confirmed that the recruitment procedure was thorough. These included references, CRB and other safety checks. Supervision is carried out monthly and staff members have a training profile to identify their training needs. Training undertaken by staff was judged to be satisfactory. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 17 The evidence gained from interviews with the resident, the manager, the member of staff on duty and the records examined supports the judgement that staff with the support of the manager provided a good standard of care. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 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, 39 & 42 Quality in this outcome area was good. This judgement has been made using evidence available on the site visit. Residents benefit from a well managed home. EVIDENCE: The inspector interviewed the resident, the manager and the member of staff on duty. The manager possesses the Advanced Management in care qualification. The manager demonstrated knowledge of the current resident’s needs and the resident was relaxed in her presence. There was a good professional relationship between the manager and the member of staff on duty. The manager’s competency to run the home was judged good based on her involvement and management of the home, her relationship with the resident and staff and the home’s high standard of hygiene. The home has developed policies and procedures and the member of staff interviewed and observed was competent. The establishment has an equal opportunities policy, which addresses issues of equality and diversity. Staff interviewed showed knowledge of the policy and of the Disability Discrimination Act 1995. The manager stated that she had been trying to recruit staff to reflect the Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 19 cultural background of the current resident. The staff on duty had a good understanding of the needs of the current resident The participation of the resident in activities for example helping in the kitchen requires risk assessments as well as review of existing policies. The registered person is required to develop a written statement of the policy, organisation and arrangements for maintaining safe working practices in the home. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 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 CONCERNS AND COMPLAINTS ~CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score Standard No 22 23 Score 3 2 3 2 X 2 X ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000017502.V290918.R01.S.doc LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harrowdene Lodge Score 3 3 3 X 3 X 3 X X 2 X Version 5.1 Page 21 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 2 Standard YA7 YA42 Regulation 12 12 Requirement Timescale for action 27/07/06 3 YA42 13 The registered person must ensure that the resident has the choice of an advocate. That the registered person 27/07/06 ensures that risk assessments on all activities of daily living are carried out, to ensure the resident’s well being. The registered person is required 27/07/06 to develop and review a written statement of the policy, organisation and arrangements for maintaining safe working practices. It is required that a record is kept of the food provided to enable any person inspecting the record to determine whether the diet is satisfactory. The registered person must obtain a copy of the London Borough of Camden policy to ensure that appropriate procedures are followed if required. 31/05/06 4 YA17 17(2) 13 5 YA23 22 31/05/06 Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 22 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 YA20 Good Practice Recommendations The registered person must ensure that the resident’s consent to medication is obtained and recorded in the individual plan. Harrowdene Lodge DS0000017502.V290918.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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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