CARE HOME ADULTS 18-65
Hart House 91 Hamstel Road Southend on Sea Essex SS2 4NF Lead Inspector
Carolyn Delaney Unannounced Inspection 10:00 9 December 2005
th Hart House DS0000039251.V261207.R01.S.doc Version 5.0 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 Hart House DS0000039251.V261207.R01.S.doc Version 5.0 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. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Hart House Address 91 Hamstel Road Southend on Sea Essex SS2 4NF 01702 619611 01702 619611 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) Mr Richard Jeremy Hart Mr Stephen David Hart Miss Helen Dawn Venning Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 3rd August 2005 Brief Description of the Service: Hart House provides accommodation for up to eight adults who have a diagnosed mental health disorder or illness. The home was originally opened so as to provide short term rehabiliative care from six to eighteen months. However residents living at the home have been supported for longer periods according to their progress with treatment etc. Hart House is a residential style property situated close to Southend on Sea town centre. People living at the home have their own personal accommodation and access to attractive, homely communal areas, including lounge / diner, kitchen and a well-maintained garden. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection was carried out between 10.00 and 12.30 on 9th December 2005. Care plans and assessments in respect of potential risks to people living at the home were assessed and two residents were spoken with. There were no relatives present during this inspection. Records in respect of staff recruitment, training and supervision were assessed and two members of staff including the registered manager were spoken with. Records maintained regarding the maintenance of premises were also sampled. Key standards as identified in the intended outcomes sections of this report are inspected at least once every twelve months. Where key standards have not been inspected on this occasion they will have been inspected at the previous inspection. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. What the service does well: What has improved since the last inspection?
The way in which staff assess, record and manage risks to people living at the home has improved since the last inspection. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 6 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. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 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 Hart House DS0000039251.V261207.R01.S.doc Version 5.0 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 the following standard(s): 0 There have been no new admissions to the home since the last inspection. EVIDENCE: Hart House DS0000039251.V261207.R01.S.doc Version 5.0 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 the following standard(s): 6, 7, 8 & 10 Residents are actively involved in all aspects of developing and planning of the care they receive and the day-to-day running of the home. Actual and potential risks are assessed and managed appropriately. EVIDENCE: Care plans are detailed and clear in respect of the needs of the people living at the home. Residents are actively involved in the planning and reviewing of care and treatment. Assessments in respect of risks to residents include details of decisions made by residents and how actual and potential risks are to be managed. People living at the home are consulted on a regular basis about how the home is managed and are involved in the day to day running of the home. Residents are supported to develop and maintain skills to enable them move towards living more independent lives in the community. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, & 16 People living at Hart House are encouraged and supported where required to participate in activities and access opportunities for personal development. EVIDENCE: A number of residents undertake training at a local adult education college. Residents have opportunities to access leisure activities in the community and to develop and maintain relationships with family and peers. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 11 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 & 21 People living at Hart House are supported and assisted to meet their personal, physical and emotional needs. Where appropriate residents are supported to retain and administer their medication. EVIDENCE: The people living at the home at the time of this inspection did not require any physical assistance regarding maintaining personal care. Some residents need prompting and encouragement so as to prevent them neglecting areas such as personal and general hygiene. Where support is required this is clearly documented in the individuals plan of care. Residents are supported and assisted in ensuring that, taking into account each persons capabilities, they take responsibility for their general health care needs such as attending appointments in respect of treatment, check ups, and blood tests etc. One resident retains control of and administers his medication as part of his plan for moving on to more independent living.
Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 12 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 Hart house has clear policies and procedures for dealing with complaints made in respect of the service. Residents living at the home are protected from abuse, neglect and self-harm. Records in respect of monies held on behalf of residents are not consistently maintained so as to minimise the risks of mishandling. EVIDENCE: Resident’s spoken with during this and previous inspections confirmed that any concerns or complaints are dealt with promptly and appropriately. There had been no complaints made in respect of the services provided by the home since the last inspection. One complaint had been received by the home from a neighbour regarding noise made by a resident. This had been dealt with and resolved satisfactorily. The home has a detailed policy and procedure in respect of protecting people who live at the home from abuse and staff receive regular training regarding the protection of vulnerable people. There were no records maintained in respect of monies received and held on behalf of one residents living at the home. This was discussed with the homes manager during the inspection. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 13 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): 0 Standards 24 to 30 were assessed at the previous inspection. There have been no changes to the environment since the last inspection. EVIDENCE: Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 14 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, 32, 33, 34, 35 & 36 People living at Hart House are supported by well-trained and supervised staff. Staff recruitment is not consistently robust so as to ensure the protection of people living at the home. EVIDENCE: All staff working at the home have clear descriptions of their roles and responsibilities. Staff are supported and receive regular supervision. All staff have appropriate off duty time and do not work excessive hours. The staff duty rota is not always fully completed with full names of agency and bank staff. Staff recruitment files, which were examined, did not include sufficient detail in respect of each individuals work history and references were not sought from previous employers. Where agency staff are employed, a detailed profile of each individual, which includes details of checks made including Criminal Records Bureau (CRB) disclosure numbers, details of training and experience are provided by the agency. All staff have received mandatory training such as fire safety and training in
Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 15 respect of the safe handling of medication etc. Three members of staff are undertaking National Vocational Qualification (NVQ) level 2 in care and four are undertaking level 3. All staff have undertaken TOPPS induction training. Records in respect of staff recruitment, training and supervision are not consistently stored in an ordered fashion. It was not clear that staff receive training in respect of meeting the specific needs of people with mental health disorders or the needs of older people. The homes manager provides health journals with information relating to the care and treatment of people who have mental illness. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 16 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): 42 Hart House is generally managed so as to best meet the safety needs of the people who live in, work at, or visit the home. EVIDENCE: Records in respect of the maintenance and repair of gas, electrical and general appliances within the home were well maintained and kept up to date. Records evidenced that regular fire safety checks and staff training were also maintained and up to date. It is was noted that following a letter from the Essex Fire & Rescue services in March 2005, which explained changes in the responsibilities of home managers in respect of assessing risks of fire etc within homes, that no risk assessment had been carried out. This was discussed with the homes manager. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 17 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 X X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 X 3 Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 2 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Hart House Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000039251.V261207.R01.S.doc Version 5.0 Page 18 YES 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 YA23 Regulation 16(2)(l) Requirement The registered persons must ensure that so far as it is practicable that all measures are taken so as to minimise the risks of mishandling of residents monies held on their behalf at the home. The registered persons must ensure that accurate records are maintained in respect of the people who work at the home. This with reference to ensuring that the staff duty rota is maintained accurate with full names of all staff who work at the home. The registered persons must ensure that all staff are recruited robustly in accordance with the homes policies and procedures and current legislation. The registered persons must ensue that staff receive training in respect of their roles and responsibilities in order to best meet the needs of people living at the home. This with reference to providing training in respect of the needs of people with mental health
DS0000039251.V261207.R01.S.doc Timescale for action 30/12/05 2 YA33 17(1) & Schedule 3 31/12/05 3 YA34 19 & Schedule 2 18(1)(c) 31/12/05 4 YA35 30/01/05 Hart House Version 5.0 Page 19 problems and the ageing process. (This requirement is outstanding from the last inspection.) 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 2 Refer to Good Practice Recommendations Standard YA36YA35YA32 It is recommended that the records maintained in respect of staff training and induction be reviewed and reorganised. YA42 It is recommended that a detailed assessment in respect of the fire risks for the home be carried out and reviewed periodically in accordance with the guidance provided by the Fire Department. Hart House DS0000039251.V261207.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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