Inspection on 04/10/05 for Harwood Road

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harwood Road 16/06/08

Harwood Road 23/05/07

Harwood Road 22/05/06

Harwood Road 08/03/06

Harwood Road 21/03/05

Harwood Road 04/10/04

Harwood Road 09/02/04

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

CARE HOME ADULTS 18-65 Harwood Road Harwood Road 95-99 Harwood Road Fulham London SW6 4QL Lead Inspector Tony Lawrence Unannounced Inspection 4th October 2005 11:00 Harwood Road DS0000019149.V255061.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 Harwood Road DS0000019149.V255061.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. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Harwood Road Address Harwood Road 95-99 Harwood Road Fulham London SW6 4QL 020 7731 7142/45 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) stuart.johnston@hestia.org Hestia Housing Mr Stuart Johnston Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st March 2005 Brief Description of the Service: Harwood Road is a registered care home providing accommodation and personal care for 15 people with mental health needs. On the day of this inspection, 4 women and 10 men were living in the home and there was one vacancy. Shepherd’s Bush Housing Association owns the property and the care is provided by Hestia Housing & Support. Thirteen service users each have a self-contained flat, with ensuite shower or bath and toilet. Two people each have a single room and share a bathroom and kitchen. The flats are situated on the ground, first and second floor of the home. There are two lounges, one smoking and the other non-smoking, and a communal kitchen area on the lower ground floor. There is also a patio/garden area to the rear of the home. The home is well located close to Fulham Broadway, providing good access to transport links and local amenities. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 4th September 2005 from 11:00 – 14:00. The Inspector spent time talking with the manager and staff and looking at care records. He also spoke with five people living in the home and saw all communal rooms. Three requirements made at the last inspection have all been met. 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. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 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 Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 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 and 5. The home has clear admission procedures and service users are supported to make an informed decision to move in. EVIDENCE: The Inspector reviewed the care plan files of three people living in the home. Two of the service users have an assured tenancy with Shepherd’s Bush Housing Association. The third person has a Licence Agreement with Hestia Housing and Shepherd’s Bush Housing Association. The service user and a member of staff from the home have signed the licence agreement and the tenancies. Since the last inspection of the home in March 2005, no new service users have moved in. The manager told the Inspector that one person is due to move on shortly and Social Services have been asked to refer people to fill this vacancy. A second vacancy was caused by the recent sudden death of a service user and the manager said this would also be filled by Social Services. The three care plan files the Inspector saw each included a care needs assessment completed by a social worker when the service user was referred to the home. The files also included evidence that staff from the home work well with staff from the health authority and the Social Services Department to make sure appropriate referrals are made to the home. Two service users also told the Inspector that people ‘usually’ come for a meal before they move into the home. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 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 and 9. The home’s care planning systems are well used by staff to get the information they need to meet service users’ care needs. EVIDENCE: The three care plan files checked by the Inspector each included an up to date care plan. Two plans were reviewed in August 2005 and one in April 2005. The plan covers the service user’s mental and physical health; personal care needs; social activities; employment and spiritual care needs. Each of the three plans included 3 – 5 short and longer-term goals. The goals are clear and measurable and include registering with a local GP, joining a computer class, going to the gym, eating healthily and managing personal finances. The goals for one person who is due to move on from the home covered selfmedication and managing finances. All three plans emphasise the importance of service users developing their skills to live independently. The plans are clearly written and service users are encouraged to sign to say that they agree with the goals. As well as the home’s own care plans, each file includes details of multi-agency review meetings to oversee the care of each person. The Inspector was impressed to see that the views of service users are clearly recorded and considered as part of their care plan. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 Page 9 Each care plan starts by highlighting the main risks that have been identified for the service user. Individual risk management assessments are then completed for each area. Two files the Inspector reviewed included excellent fire safety risk assessments for service users who smoke and the Inspector noted that these have been regularly reviewed. Other risk assessments were well written and covered the use of alcohol and the risk of violence. Harwood Road DS0000019149.V255061.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, 15, 16 and 17. The home has good links with the local community and services, offering service users a choice of social and educational opportunities. EVIDENCE: The home has two lounges, one for people who smoke and one that is nonsmoking. Each lounge is comfortably furnished and there is a piano, TV, computer and selection of books in the non-smoking lounge. There is also a TV and video in the smoking lounge. Both lounges have recently been redecorated and offer attractive spaces for service users. There is a patio / garden with furniture and flowerbeds. The Inspector saw service users in the garden enjoying the unseasonably warm weather during this inspection. Care plans include evidence that service users are supported to make links with local employment, education and leisure services, including adult colleges and specialist day services for people with a mental illness. One service user told the Inspector that he enjoys learning new skills at a local carpentry project. Other service users said they used local cafes and pubs. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 Page 11 Care plans include details of each person’s next of kin and other significant people, including friends and other relatives. There is evidence in the files that staff support service users to maintain contact with relatives and other people, if this is their wish. One service user also told the Inspector that he was planning to go on holiday with a relative later this year. Service users told the Inspector that they have keys to their rooms and the home’s front door. They also said that staff use the name they prefer when talking with them; the Inspector also saw that this is recorded as part of the care plan. Breakfast is provided for service users and each person is given a weekly allowance to buy food for their own lunch and evening meal. Care plans show that staff support individuals to develop their catering skills. Thirteen flats in the home have their own kitchens and service users in two other flats share a kitchen. Three service users told the Inspector that they greatly enjoy the communal Sunday lunch that is cooked by staff each week. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 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 and 20. Service users’ personal care needs are well recorded. Prescribed medication is well managed in the home by staff. EVIDENCE: The three care plan files the Inspector saw during this visit included clear information about each person’s personal care needs and preferences about how these are met in the home. Staff told the Inspector that most service users need no physical help with their personal care, but most need prompting to have a bath or shower. Most people living in the home have a shower or bath, wash basin and toilet in their flat. Two people share a bathroom. The care plans the Inspector saw detail how people living in the home are supported to be as independent as possible with their personal care. Service users told the Inspector that they are happy with the facilities and support they get at Harwood Road. The home uses the Boots Monitored Dosage System for all prescribed medication. The Inspector checked the Medication Administration Sheets for 13 people living in the home. All medication is securely stored in the office and standards of recording are very good. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 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 and 23. The home has a satisfactory complaints procedure and service users feel their views are listened to and acted upon. EVIDENCE: To assess these Standards the Inspector spoke with five people living in the home and checked the record of complaints. People are very positive about life at Harwood Road. Staff are described as ‘good’, ‘very good’ and ‘kind’. Services users said that staff are always available to offer advice and support. One person said that all staff, and especially his key worker, have been very supportive as he is preparing for a move. The Inspector saw three care plan files and each contains a copy of the organisation’s complaints procedure. Hestia must ensure that the procedure is reviewed to include the correct contact details for the Commission. The home’s record of complaints is well organised. Eleven complaints have been recorded in 2005. The record includes details of actions taken and the outcomes for the service user making the complaint. Accidents and incidents involving people living in the home are well recorded but there is a need to make sure that the Commission is always informed of significant events. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 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, 28 and 30. The standard of accommodation is good and provides service users with a comfortable and homely place to live. EVIDENCE: The home consists of three interlinked terraced properties on a busy road close to the shops and transport links of Fulham Broadway. The home is not accessible to people with a physical disability or limited mobility, as there are steps to the front door and internally. There are thirteen self-contained flats with ensuite bath/shower room, toilet and kitchen and two bedrooms with shared bathroom and kitchen. There are two lounges, one smoking and one non-smoking. There is an attractive and spacious patio/garden area and a large communal kitchen. To assess these standards, the Inspector saw all communal parts of the home. Four people living in the home said they are very happy with their flats, but said they did not want the Inspector to see them. Work to redecorate the communal areas and the exterior of the home has almost been completed. Service users said that they have been involved in choosing colour schemes for the communal lounges. The Inspector thought the smoking and non-smoking lounges provide very comfortable spaces for service users. All communal areas were clean and tidy. Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 Page 15 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 and 35. Staff in the home are enthusiastic and work positively with service users to improve their quality of life. EVIDENCE: The Inspector spoke with three members of staff and the home’s manager during this visit. Staff on duty were able to describe their responsibilities and they worked well together to ensure the care needs of people living in the home were met appropriately. Staff told the Inspector that they were satisfied with the supervision they receive from managers and the training opportunities offered by Hestia. During this visit the manager was on duty and the deputy manager was attending a training course. Three Project Workers and one Project Support Worker were also on duty. The Inspector feels that this is an adequate level of staffing to meet the needs of the people living in the home. The manager confirmed that all staff working in the home are registered on NVQ Level 2 or Level 3 training courses. One person working in the home already has a NVQ Level 3 qualification. Although the home will not meet the target for 50 NVQ qualified staff in 2005, this should be achieved during 2006. Harwood Road DS0000019149.V255061.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): 37, 39, 41 and 42. The home is well managed by an experienced and qualified manager. Service users benefit from good standards of care and record keeping. EVIDENCE: There has been no change in Manager since the last inspection. The manager is well qualified and holds a BA (Hons) degree in Social Science and a Diploma in Psychotherapy and Hypnotherapy. He is also completing the NVQ Level 4 Registered Managers Award and the NVQ Assessor’s Award. The Inspector feels the manager has a clear development plan for the home and that this is well communicated to staff. The Inspector saw a selection of care records, including care plan, risk assessments, medication and health and safety records. Al records are well maintained by staff and are up to date. No health and safety issues were noted during this visit. Harwood Road DS0000019149.V255061.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 3 X X 3 Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X 3 X 3 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 X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harwood Road Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 3 X DS0000019149.V255061.R01.S.doc Version 5.0 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA22 Regulation 22 Requirement Hestia must ensure the complaints procedure includes contact details for the Commission. The manager must make sure that the Commission is told of any significant events affecting people living in the home. Timescale for action 31/12/05 2 YA23 37 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Harwood Road DS0000019149.V255061.R01.S.doc Version 5.0 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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