Inspection on 26/03/08 for Hart View

This inspection was carried out on 26th March 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hart View 13/01/09

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

CARE HOME ADULTS 18-65 Hart View 4 Valkyrie Road Westcliff On Sea Essex SS0 8BU Lead Inspector Carolyn Delaney Unannounced Inspection 26th March 2008 11:00 Hart View DS0000070714.V361322.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 Hart View DS0000070714.V361322.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. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hart View Address 4 Valkyrie Road Westcliff On Sea Essex SS0 8BU 01702 433330 01702 433330 hatview@sky.com 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) R Hart Care Ltd Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disabilities, or dementia - code MD Date of last inspection N/A Brief Description of the Service: Hart View is a residential care home, which provides personal care only for up to a maximum of eight younger adults who have a diagnosed mental disorder. The aim of the home is to provide care and support so as to rehabilitate people so that they can live independently within the community. The usual period a person will stay in the home is two years however the period depends upon the needs of each individual. The home is an older style property, which is situated in Westcliff on Sea, close to local shops and amenities and the seafront. The fees for a place at the home range from £870 to £ 1170 per week. This is the first inspection of the service since it was registered with the Commission for Social Care Inspection. Hart View DS0000070714.V361322.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 was a routine unannounced inspection, which was carried out between the hours of 11.00 and 18.00 on 26th March 2008. This was the first regulatory inspection since the home was registered in November 2007. As part of the inspection residents and staff were spoken with and offered the opportunity to complete surveys and the information collated in these was used to form judgements about the service provided to residents. Records including residents care plans and staff records were sampled and examined during the site visit. A brief tour of the home was carried out. What the service does well: Hart View had been open and accepting residents for approximately five weeks prior this inspection visit. The home provides a safe, comfortable and homely environment for residents. Staff assist and support residents in making decisions about their lives. Residents are encouraged to be as independent as possible according to their individual needs and capabilities. Where risks are identified to the health and safety of residents staff support residents so as to minimise these risks without hindering the individual’s rights to choice and independence. Residents have access to healthcare professionals according to their needs and are supported in attending routine and specialist appointments. Resident’s health is monitored regularly and each person has a plan of care developed with him or her, which sets out how the person wishes to be supported. Care plans are reviewed regularly so as to ensure that care and treatment is effective. Staff are recruited robustly and all appropriate checks are carried out to help assure that staff working at the home are competent and suitable to care for the residents. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Hart View DS0000070714.V361322.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 Hart View DS0000070714.V361322.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): 2, 4 & 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The failure of staff to assess prospective residents needs means that residents cannot always be assured that the home will meet their needs and aspirations. EVIDENCE: It is the policy of Hart View that before residents are offered a place in the home they will have an assessment of their needs carried out by the homes manager. However no assessment had been carried out for the residents currently living there so as determine that the home would be suited to their needs. Each of the three residents living were spoken with and completed surveys. Each said that they had been provided asked if they would like to move into the home. Prospective residents are actively encouraged to visit the home and to meet with staff and other residents at least once so as to ‘test drive’ the home to see if they feel they will be happy living there. Each of the three residents said that they had visited the home at least once before making the decision to move in. One resident said that they had been ‘nervous about the move’ but that staff were very friendly and supportive on Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 9 the day of admission. Another resident said that they ‘couldn’t believe their eyes’ when they saw the home for the first time as it was ‘so good’. The other resident said that their social worker had ‘discussed the home with them in detail’. Each of the three residents had a written contract in respect of the terms and conditions of living in the home, which they had agreed and signed. Hart View DS0000070714.V361322.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Hart View are supported and receive care, which meets their individual needs so that they can live their lives as safely and independently as possible. EVIDENCE: Each person living in the home had a plan of care developed identifying their needs and the support they required. There was evidence that residents had been involved in the development of the care plan. Residents said that they were provided with a copy of their individual plan of care. Care plans were reviewed regularly and amended according to any changes in the needs or treatment of residents. All three of the residents said that they could make decisions about what they do each day. One resident said that they enjoyed going to the pub with friends. Another said that they go shopping, to the cinema and go out for meals. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 11 During the inspection residents spent their time as they chose to. Residents went out shopping, out for walks, visiting friends or spent time in the home watching television or playing card games with staff. Where risks to a resident’s welfare were identified then action was taken so as to minimise these risks without hindering the person’s capacity to spend their time as they chose. For example where it was identified that residents were at risk or felt vulnerable when accessing activities in the community then staff would provide support and escort the resident. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 12 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): 12, 13,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Hart View are encouraged and supported to live their lives as independently as possible so that they can one day live more independently in the community. EVIDENCE: All three of the residents felt that they could participate in activities of their choosing including socialising with friends and family and accessing activities within the local community. Residents had only been living in the home for a few weeks at the time of this inspection. One resident said that they were interested in painting and decorating and was looking for a course at local colleges. Another resident was being supported in accessing a cookery course. In addition staff were arranging for two residents to access day centre activities locally. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 13 The aim of the home is to promote residents’ independence and to support residents in developing skills so that they can live independently within the community. As part of this residents are encouraged to purchase and prepare meals. Residents are supported according to their needs and capabilities. Residents said that they enjoy shopping and preparing meals and that they had the choice about what foods they ate. Residents showed the inspector what meals and food they had recently bought and the storage arrangements for food in the home. Residents plan each week’s menu, which reflects their choices. Alternative meals are available. Staff had carried out a nutritional assessment for residents when they moved into the home and residents are encouraged and supported to choose a good range of healthy food as part of their diets. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 14 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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Hart View receive a good level of care and their physical and men healthcare needs are met. EVIDENCE: At the time of this inspection the residents living in the home were self-caring in respect of their personal care needs. Two residents were supported in attending doctor and other health related appointments. It was positive to note in one residents care plan that healthcare professionals who were involved in the persons treatment had commented about the improvement in the resident since they moved into Hart View. Staff and residents meet for one to one sessions where any emotional issues are discussed and residents are given the opportunity to discuss any worries they may have. One resident said that they find these sessions very useful. Residents said that staff administer their medicines. One resident said that they are happy with this, as they tend to ‘forget to take tablets’. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 15 There was no evidence that an assessment had been carried out for residents so as to determine whether they were capable of safely retaining and administering medicines. The manager said that these assessments should have been carried out and that residents would be supported in developing competence and confidence in managing their medicines as part of their rehabilitation. Staff who were responsible for the receipt, administer, storage and disposal of medication in the home had received training. Records were clear and well maintained so as to evidence that residents receive the medication prescribed for them as part of their individual treatment. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 16 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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are listened to and that their welfare is protected. EVIDENCE: There is a clear policy and procedure for describing how any complaints made will be dealt with and responded. Each of the three residents confirmed that they were aware of who to speak with if they were unhappy or if they needed to make a complaint. Residents said that they had no cause to make any complaints since they moved into the home. Staff on duty at the time of the inspection completed surveys and said that they were aware of what to do if a resident or other person such as relatives or advocates had any concerns about the home. One resident said that staff are very ‘calm’ when dealing with any issues. One resident said that ‘there is always a member of staff available to discuss any problems they might have’. All three felt that staff listen and act on what they say and that staff treat them well. One person said that they ‘get well looked after on a daily basis’. A sample of staff recruitment files were assessed and there was evidence that Criminal Records Bureau (CRB) disclosures and PoVA First checks had been carried out for staff before they commenced work at the home. This helps to ensure that people working in the home are suitable to provide care and support to people who may be vulnerable. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 17 Staff training records did not evidence that all staff working at the home had received training in respect of safeguarding residents from harm, abuse or neglect, which is recommended to help ensure that all staff are aware of what to do if they witness or suspect ill treatment of residents. Staff who completed surveys and who spoke with the inspector during the inspection visit could demonstrate that they were aware of the appropriate action to take if they witnessed or suspected any ill treatment of people living in the home. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 18 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 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Hart View is clean, comfortable and safe and provides suitable personal and communal spaces for people who live there. EVIDENCE: Hart View is a larger detached older style property situated close to local shops and amenities and the sea front in Westcliff on Sea. The home comprises of eight single bedrooms and communal areas including a large lounge diner, modern fitted kitchen and laundry room. Bedrooms and communal areas were decorated to a very high standard and residents and staff said they were happy with the accommodation in the home. Residents said that the home is always clean and fresh. One person commented that they enjoy the ‘sky television’. Residents have access to a garden area and one of the residents who has an interest in gardening plans grow some plants in the near future. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 19 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, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are recruited robustly and residents are well looked after and safeguarded. EVIDENCE: Residents all spoke highly of staff working in the home. They commented that staff are kind, caring and friendly. During the inspection it was observed that staff and residents had developed positive relationships and residents felt that staff looked after them and treated them well. Staff who completed surveys said that they felt that they had the skills, support and experience to support residents. One member of staff said that they ‘are given support and are learning more and more each day about how to give support to residents’. Staffing levels at the home were two staff to support three residents. Both staff and residents said that they felt that there were enough staff employed to meet residents needs. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 20 The recruitment files for two people who were employed at the home recently were examined. There was evidence that evidence that Criminal Records Bureau (CRB) disclosures and PoVA First checks had been carried out for staff before they commenced work at the home. References had been sought from candidate’s previous employers so as to determine their fitness to work providing support to residents. The manager said that candidates were interviewed but that records were not kept in respect of this Some but not all staff files contained certificates in respect of training, which staff have undertaken such as training in respect of the administration of medicines, safeguarding people from harm and infection control. However there was no evidence that staff had received training in respect of supporting people with schizophrenia. One member of staff commented that more training could be provided in respect of supporting people with mental health issues and rehabilitation. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 21 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 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of consistent management of the home impacts upon on experience for people who live there. EVIDENCE: At the time of this inspection the manager from the organisations sister home was providing management support. She had been at the home for two weeks. Two managers have left the home since it was registered. As a result there were a number of areas as identified throughout the inspection report where improvements need to be made. Residents and staff feel supported by the current manager. Residents feel that their views and comments are taken into account. There is a system in place for monitoring the quality of service provided and the views of people who live Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 22 in the home and their relatives or advocates. However as the home had only recently opened this had not been implemented at the time of this inspection. Records in respect of monitoring, maintenance and repair of equipment and systems such as the systems for detecting an outbreak of fire at the home were not available. However there were no safety issues identified during the inspection. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 23 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 X 2 1 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 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 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X X X X 2 X Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 YA2 Regulation 14(1) Requirement Timescale for action 30/05/08 2. YA35 18 (10 (c) (i) 8 (1) (a) (b) 3. YA37 4. YA42 17 A full assessment of each person’s needs must be carried out before they are offered a place at the home so as to ensure that the home will be suited to the individual. Staff working at the home must 30/05/08 receive training in respect of the roles they are to perform and the needs of the residents. A manager must be appointed to 30/05/08 the home so as to ensure that is run in a consistent way and in the best interests of the people who live there. Records in respect of the 30/04/08 maintenance repair and renewal of the premises and any electrical, gas, fire safety and mechanical equipment must be available for inspection and kept accurate and up to date so as to evidence that the home is safe for residents and staff. Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 25 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 Standard YA20 YA23 Good Practice Recommendations Residents should be assessed in respect of their capabilities regarding retaining and administering their medicines as part of their rehabilitative programme. All staff working at the home should undertake regular training in respect of safeguarding people from abuse and self-harm, so as to help ensure consistency in staff’s approach to safeguarding issues. Where interviews are carried out as part of the recruitment process, records in respect of the interview should be maintained so as to demonstrate the suitability of individual candidates. 3. YA34 Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Hart View DS0000070714.V361322.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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