Inspection on 08/03/06 for Harwood Road

This inspection was carried out on 8th March 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 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 04/10/05

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 8 March 2006 09:15 th Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 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.V280604.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 Brief Description of the Service: Harwood Road is a registered care home providing accommodation and personal care for fifteen people with mental health needs. Four women and eleven men are living in the home and there is 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, the staff office 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.V280604.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Wednesday 8th February 2006 from 09:15 – 11:45. The Inspector spoke with three people living in the home, the acting manager and staff on duty. He also saw two bedrooms and all communal areas and checked care records. Two requirements made at the last inspection have 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.V280604.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 and 5. The home has clear procedures for the referral and admission of new service users. EVIDENCE: Key Standard 2 was met at the last inspection in October 2005. Since the last inspection three new people have moved into the home, two people have moved on and one person has died. The Inspector checked the care records for one person who moved into the home recently. The care plan file was well organised and included a referral form, a care needs assessment, a current risk assessment and detailed hospital discharge summary. Staff from the home have also updated the risk assessment and developed a temporary care plan with the service user. The service user told the Inspector that they had visited the home twice before moving in, to meet staff and other people living in the home. The service user said that they had signed a tenancy agreement and the Inspector also saw this on the care plan file. The home has developed a useful induction programme for new service users that should be completed with their key worker. The induction programme checked during this visit was only partially completed, although the person has lived in the home for almost two months. Staff should make sure that new service users have this important information explained to them as soon as possible after they move into the home. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 9. Service users are well supported to take part in all aspects of life in the home. Standards of risk management are good. EVIDENCE: All three key Standards were met at the last inspection in October 2005. The Inspector spoke with three service users and all said that they felt staff supported them to make choices about the care they receive. All three people were very positive about the home’s staff team and the support they provide. The service user’s care plan file reviewed by the Inspector showed clear evidence that the person’s care needs are assessed well. Potential risks have also been identified and action taken to ensure the person is cared for safely. The need for staff to make sure risk assessments are followed is covered later in this report (see Standard 23). Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 9 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): EVIDENCE: All five key Standards were met at the last inspection in October 2005. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 10 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): 20. Medication is well managed in the home and service users are supported to manage their own medication wherever possible. EVIDENCE: All three key Standards were met at the last inspection in October 2005. During this visit the Inspector checked the Medication Administration Record (MAR) sheets for people living in the home. The home uses the Boots Monitored Dosage System. Prescribed medication is delivered every 28 days and secure storage is provided in the home’s main office. The MAR sheets are well completed by staff and the Inspector found no errors or omissions. The records for three service users show that they are being supported by staff to manage their own medication. Responsibility is transferred gradually from the staff team to the service user and this is well recorded. The care plan file reviewed by the Inspector included a letter from the service user refusing medication. Staff confirmed that this had been discussed and agreed with the multi-disciplinary team responsible for the person’s care. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 11 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. Procedures are in place to make sure service users are cared for safely but staff must follow these consistently. EVIDENCE: The two key Standards were not met at the last inspection in October 2005. Since then the home’s complaints procedure has been updated and staff have made sure that the Commission is kept informed of significant incidents involving service users. Staff told the Inspector that there have been no formal complaints since the last inspection. Other issues, including disagreements between people living in the home are usually resolved informally or in the regular house meetings. Staff also told the Inspector that they are not involved in the management of service users’ finances. The care plan and risk assessment reviewed by the Inspector highlighted that the person is vulnerable to exploitation. Daily progress notes completed by staff show that, since moving into the home, the service user has frequently stayed out late at night and staff are unaware of their whereabouts. Although this has been discussed with the service user, their doctor and care manager, staff from the home should make sure that the Social Services Department is told each time the person does not return home at night. The person’s risk assessment should also be reviewed to make sure these issues are covered. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 12 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, 25, 26, 27, 28 and 30. The home provides a good standard of accommodation that enables service users to develop their independent living skills. EVIDENCE: Both key Standards were met at the last inspection in October 2005. During this visit the Inspector saw all communal areas, bathrooms and toilets and two service users’ bedrooms. Communal rooms are well decorated and furnished and there is a sufficient number of bathrooms and toilets for service users. Both bedrooms are well decorated and furnished. Most of the rooms have ensuite bathrooms and a kitchen. Service users told the Inspector they enjoy using the kitchens in their rooms to prepare meals and drinks. All parts of the home seen during this visit were clean and hygienic. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 13 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, 33, 34 and 35. The home is well staffed to meet service users’ care needs. EVIDENCE: All three key Standards were met at the last inspection in October 2005. During this unannounced inspection, the acting Manager was on duty with three Project Workers and a Project Support Worker. The Inspector felt this level of staffing was sufficient to meet service user’s care needs and staff worked well together to make sure individuals were supported appropriately. The acting Manager was not able to provide the Inspector with a list of staff Criminal Record Bureau checks. Hestia must make sure that the Commission is provided with these details. The acting Manager confirmed that one Project Worker has completed their NVQ Level 3 qualification training; 3 Project Workers have started their NVQ Level 3 training and 3 Project Support Workers have started their NVQ Level 2 training. Although the home has not met the target of 50 qualified staff by 2005, this should be achieved during 2006. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 14 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): 41, 42 AND 43. The home is well managed, standards of recording are good and there are no health and safety concerns. EVIDENCE: All three key Standards were met at the last inspection in October 2005. During this visit the Inspector checked one service user’s care plan and risk assessments, daily progress notes for three people and medication records for other service users. All records were well maintained and up to date. No health and safety issues were noted during this visit. Managers from Hestia Housing carry out monthly monitoring visit to the home. Copies of reports written after each visit are sent to the home and the Commission. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 15 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 2 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 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 3 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X X X 3 3 3 Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 16 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 YA34 Regulation 19 Requirement Hestia must provide the Commission with the details of staff CRB checks. Timescale for action 30/04/06 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 YA3 YA23 Good Practice Recommendations Staff should complete the induction checklist with new service users as soon as possible after admission. Staff from the home should make sure that the Social Services Department is told each time a service user does not return home at night. The person’s risk assessment should also be reviewed to make sure these issues are covered. Harwood Road DS0000019149.V280604.R01.S.doc Version 5.1 Page 17 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.V280604.R01.S.doc Version 5.1 Page 18 - 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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