Inspection on 15/01/07 for Hartley House

This inspection was carried out on 15th January 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hartley House 25/07/06

Hartley House 17/02/06

Hartley House 05/07/05

Hartley House 07/10/04

Hartley House 06/05/04

Hartley House 07/01/04

Hartley House 12/06/03

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Brook Drive, 124

Rugby House Project

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

CARE HOME ADULTS 18-65 Hartley House 31 Madeley Road Ealing London W5 2LS Lead Inspector Robert Bond Key Unannounced Inspection 15th January 2007 10:00 Hartley House DS0000027732.V324597.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 Hartley House DS0000027732.V324597.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. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartley House Address 31 Madeley Road Ealing London W5 2LS 0208 997 0022 0208 810 5384 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) www.turning-point.co.uk Turning Point Limited *** Post Vacant *** Care Home 12 Category(ies) of Past or present alcohol dependence (0) registration, with number of places Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 3 service users over the age of 65 years including service users resident in the home prior to their 65th birthday. 25th July 2006 Date of last inspection Brief Description of the Service: Hartley House is a well-established service offering rehabilitation for the maximum period of six months, for people who have an alcohol dependency and wish to adopt an alcohol free lifestyle. The establishment is owned and managed by Turning Point. Turning Point is a national social care charity providing a range of community based projects for people recovering from alcohol and drug addictions, mental illness and learning disabilities. Turning Points first service was opened in 1964. Hartley House accommodates a maximum of twelve men or women. There are 10 single bedrooms and one double room. The service provides group therapy and one to one key work sessions. Emphasis is also placed on service users participation in the community. The home is staffed from 9am - 5pm Monday to Friday. Service users can contact staff outside of these hours on a free phone number. The cost is £446 per week. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the second ‘key’ inspection of the inspection year. The Inspector assessed the home’s performance against the key National Minimum Standards (NMS) for care homes for younger adults. The Inspector sent out questionnaires in advance of the inspection and received six responses that were all positive. The Inspector visited the premises, interviewed the Manager Designate, met other staff and service users, and examined a variety of records. On the day of the inspection there were 10 service users present. The home had one staff vacancy that was about to be filled. The Inspector found that 2 of the anticipated outcomes were exceeded, and 20 anticipated outcomes were fully met. The Inspector made 3 recommendations, but no requirements were made. The standard of the home as measured by its compliance with the NMS has improved considerably. All 13 of the requirements from the previous CSCI inspection report have been fully met. What the service does well: What has improved since the last inspection? Complete records of referrals, assessments and assessment decisions are now kept. A photograph of every service user is on file unless the service user signs to say that they refuse to provide one. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 6 Risk assessments are fully completed. Staff have received additional training in how to undertake a risk assessment. Suitable arrangements have been made concerning disposal of old medication. The home now has a copy of the London Borough of Ealing’s Safeguarding Adults procedure, the in-house procedure has been updated, and staff have been trained in applying the procedure. More comprehensive training records are now being kept. Regulation 26 reports are now being sent to the CSCI on a monthly basis. Internal quality monitoring systems have been improved. All cleaning chemicals that come under the C.O.S.S.H. regulations are now stored safely. 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. Hartley House DS0000027732.V324597.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 Hartley House DS0000027732.V324597.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective users’ individual aspirations and needs are fully assessed. EVIDENCE: The Inspector chose two service users’ care files at random and undertook case-tracking. The Inspector found that good quality assessments had been undertaken by a member of staff from the care home prior to the service user being accepted for residence. The assessment is used to assist in the completion of a care plan. If a place at the home is refused, this is put in writing together with the reasons why. Most service users are referred and paid for by local authorities. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users know that their assessed and changing needs and personal goals are well reflected in their individual plan. Service users are well enabled to make decisions about their lives, subject to the rules of the home. Some excellent examples of consultation and empowerment are to seen within the home. Service users are well supported to take risks as part of an independent lifestyle, subject to the rules of the home, which service users have to agree to. EVIDENCE: The Inspector case-tracked two care files chosen at random. Both files contained a care plan that is developed as the period of residency continues. The period of residency is usually six months. The first care plan examined related to a service user who had moved in 5 weeks before. The care plan date not yet been signed and dated. The Manager Designate reported that initial care plans should be completed within three weeks but that sometimes the Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 10 service user has pressing needs to address as part of their settling in, and hence the completion of care plans is sometimes delayed. The Inspector recommends that the initial care plan is completed sooner, see Recommendation 1. A similar instance of a care plan not being completed on time is flagged up in the November 2006 Regulation 26 report by Turning Point’s Locality Manager. The second care plan examined had been written by the service user herself. This empowering process that insures a person-centred approach to care planning is commended. Care plans are reviewed at 2, 4 and where appropriate 6 monthly intervals. Risk assessments are undertaken on admission and they are reviewed at 3 weeks, 2, 4 and 6 months. A matrix is kept of all review dates due. Service users are fully involved in decisions about their care, individually and collectively at daily, and weekly meetings. The Manager Designate reported that he intends to restart six weekly Community Meetings. He also reported that a service user had played a full part in the recent short-listing and interviewing of applicants for a vacant support worker post. This practice is also commended. The home also obtains service users views formally using questionnaires. The Manager Designate reported that a revised feedback form was being devised so that service user confidentiality was further enhanced. This development is also commended. The Inspector examined two risk assessments completed on service users. Both were satisfactorily completed, with all appropriate risks having been identified and measures put in place to minimise the risks. Independence is fully promoted within the home, subject to clear rules that service users have to sign up to. For example the home is not staffed during the evenings, and nights, and not at all at weekends. Thus service users have to take responsibility totally themselves during these unstaffed periods, although an on-call staff duty system does operates during these periods. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are sufficiently encouraged to take part in age, peer and culturally appropriate activities that do not involve consuming alcohol. Service users are well encouraged to undertake leisure activities, in the home and in the local community, and to maintain family relationships. Service users’ rights and responsibilities are well recognised, subject to the home’s rules. Service users enjoy communal lunches on weekdays, and a reasonably healthy diet. EVIDENCE: The Manager Designate explained that Hartley House is a ‘second stage’ home where service users may stay for up to six months having completed elsewhere a programme of detoxification from alcohol addiction. The home offers a programme of therapeutic activities such as group therapy sessions and art therapy. Service users are encouraged to go out and lead a normal life without alcohol. Hence college attendance is encouraged, as is going to the gym or swimming. Hartley House will pay for service users to undertake these Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 12 activities, and ‘travel cards’ are supplied. There are particular links with Thames Valley University for IT training. Links with family and friends are encouraged provided these are not contra-indicated as likely to encourage the drinking of alcohol. For the first two weeks of their stay, service users may not leave the premises without another service user to escort them. Visiting times are restricted so that group therapy times are not disturbed. Bedroom searches are not undertaken but rooms are entered by staff members to undertake health and safety checks. Random breath and urine checks are undertaken to ascertain whether a service user has started drinking again. Service users are issued with a key to their own room, and a lockable cabinet. The Inspector noted a record of the food eaten on weekdays. It was reasonably healthy. Main meals are prepared by service users on a rota basis and are eaten communally. At weekends, two service users are given the responsibility and the money to buy the food for everyone, taking into account all personal preferences, and the need to purchase staple foods. The receipts are subsequently checked by the management to ensure that the food bought is of a sufficiently nutritious standard. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive good personal support (but no personal care) in the way they prefer and require. Service users’ physical and emotional health needs are well met. Service users retain control of their own medication, and are well protected by the home’s medication procedures. EVIDENCE: The Manager Designate confirmed that prospective service users with personal care needs were not accepted by Hartley House. He added that a local GP would take responsibility for new service users if they did not wish to stay with their existing GP. A similar arrangement exists with a local dentist. District nurse input is available if necessary. Service users are assisted to keep hospital appointments. The Inspector observed from the care plans examined that personal support and health care needs are addressed within individual care plans. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 14 All service users are able to manage their own medication. The home has an arrangement with the local GP concerning the return for destruction of any unused medication that is left at Hartley House when a service user leaves. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can feel that their views are fully listened to and acted upon. Service users are well protected from abuse, neglect and self-harm in terms of policies and procedures in place, EVIDENCE: The Inspector examined the home’s complaints procedure, which made reference to the CSCI, and the home’s record of complaints. No complaints had been made in recent times. The Inspector noted that the home has a copy of the London Borough of Ealing’s Safeguarding Adults procedure, which is referred to in the home’s own procedure. The Inspector saw records that demonstrated that staff members have been trained in POVA. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 16 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 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live in a very homely, comfortable and safe environment that is sufficiently clean and hygienic. EVIDENCE: The Inspector toured the premises in the company of the Manager Designate who reported that most areas had been refurbished and redecorated since the previous inspection. All decor, furniture and items of equipment were seen to be in excellent condition and, with the exception of one bath, sufficiently clean. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is not currently a full staff team in place, hence service users are not sufficiently supported by competent and qualified staff. Service users are adequately protected by the home’s recruitment policy and procedures. Staff members do have qualifications but not the required NVQ’s as yet, hence service users’ needs may not be adequately met by appropriately trained staff members. EVIDENCE: The Inspector examined the staff rota. The staffing arrangement is that all the staff are on duty all day, every week day. The establishment is Manager, three support workers, and an administrator. During evenings, nights and at weekends, the manager and support workers take turns to be ‘on call’ from home, for one week at a time. The on call worker has a mobile phone that is passed around for the purpose of taking calls from service users in the home. The on call worker is expected to return to the care home as required. Currently there is one support worker vacancy, not covered by relief or agency workers, and the Manager Designate mentioned the stress that this omission places on the remaining staff. This post has been vacant for at least six Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 18 months and the adverse effect of the vacancy was reported by the CSCI at their inspection of Hartley House on 25th July 2006. See Recommendation 2. A new support worker is in the process of being recruited. The Manager Designate reported that the new worker is due to start work on 22nd January 2007. On the day of the CSCI inspection (15th January), only one reference had been received back and the CRB disclosure check was not back. The Inspector made clear that unless a satisfactory second reference was obtained, and a clear POVA First check obtained, the new worker could not start work in a care home even if he was going to be closely supervised. The Inspector examined the home’s staff training records, which were much improved. The Manager Designate reported that the two existing support workers were undertaking level 3 NVQ’s, but did not have level 2, and that the new support worker did not have the NVQ award either, although he did have other qualifications. The NMS state that at least 50 of the care staff in a care home must achieve at least NVQ 2 in care. See Recommendation 3. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit substantially from a well run home. Service users’ views are well taken into account when monitoring, reviewing and developing the home. The health, safety and welfare of service users are well promoted and protected. EVIDENCE: The Manager Designate reported that he has been appointed by Turning Point as the Manager of Hartley House, and that he is now seeking to become the Registered Manager, subject to CSCI registration arrangements. He is also planning to obtain the Registered Managers Award and NVQ level 4 in care. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 Page 20 The Inspector examined evidence of service user questionnaires being completed, and analysed, and an annual Business Plan being developed that took into account the service users’ views. The Inspector noted evidence that the premises are adequately risk assessed, that fridge and freezer temperatures are monitored, and that the contents of first aid boxes are checked regularly. Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 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 Standard No Score 1 x 2 3 3 x 4 x 5 x 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 3 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 Score 3 4 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Hartley House DS0000027732.V324597.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 3 Refer to Standard YA6 YA32 YA35 Good Practice Recommendations Initial care plans that have been signed and dated by the service user, should be in place within three weeks of the service user moving in. The vacant support worker post should be filled as soon as possible. The support workers should be provided with every possible opportunity and encouraged to complete their NVQ awards. 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